{"id":10231,"date":"2026-10-07T14:52:51","date_gmt":"2026-10-07T13:52:51","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=10231"},"modified":"2026-10-07T14:52:52","modified_gmt":"2026-10-07T13:52:52","slug":"risk-mitigated-day-case-total-thyroidectomy-for-thyrotoxicosis-analysis-of-factors-allowing-same-day-discharge-2026","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2026\/10\/07\/risk-mitigated-day-case-total-thyroidectomy-for-thyrotoxicosis-analysis-of-factors-allowing-same-day-discharge-2026\/","title":{"rendered":"Risk mitigated day case total thyroidectomy for thyrotoxicosis: analysis of factors allowing same day discharge (2026)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Type of publication:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Journal article<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Author(s):<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">*Crossdale M.; *Walkden G.; *Hari C.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Citation:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ambulatory Surgery. Conference: British Association of Day Surgery Annual Conference. London United Kingdom. 32(3) (pp 185), 2026. Date of Publication: 01 Jul 2026.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Abstract:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Introduction The day case potential of total thyroidectomy has been limited by three primary risks: post-operative haemorrhage, recurrent laryngeal nerve injury with subsequent airway embarrassment and symptomatic hypocalcaemia. In response to rising elective backlogs, transitioning to a day-case model offers significant resource optimisation and improved patient satisfaction. We present the initial outcomes of a pilot day-case total thyroidectomy pathway within an NHS Trust. Methods Five consecutive patients underwent total thyroidectomy under a standardised day case protocol. The pathway prioritised: * Patient selection and education: strict surgical, anaesthetic and social criteria, informed consent and education around day case management. * Pre-operative optimisation: prophylactic loading with oral calcium and alfacalcidol. * Surgical strategy: meticulous surgical strategy (advanced bipolar techniques, haemostatic adjuncts, and Valsalva manoeuvres) to avoid drain insertion. * Biochemical monitoring: immediate post-operative PTH and serum calcium measurement. * Intended same day discharge: minimum postoperative stay 6 hours and until 20:00. * Post-operative safety net: discharge on a calcium\/ alfacalcidol regimen with day one telephone follow-up and mandatory 48-hour biochemical review. Results The pilot achieved a 100% same-day discharge rate (n = 5). No post-operative haemorrhages or hematomas occurred. One patient was readmitted following the 48-hour review for mild hypocalcaemic symptoms, requiring one night of oral optimisation. The remaining four patients remained asymptomatic with stable biochemistry. Conclusion Preliminary results suggest day-case total thyroidectomy is feasible for selected patients when supported by a pathway that mitigates post-operative anaesthetic and surgical risks. While hypocalcaemia remains a concern, prophylactic supplementation and structured follow-up facilitate safe management in an ambulatory setting.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Journal article Author(s): *Crossdale M.; *Walkden G.; *Hari C. Citation: Ambulatory Surgery. Conference: British Association of Day Surgery Annual Conference. London United Kingdom. 32(3) (pp 185), 2026. Date of Publication: 01 Jul 2026. Abstract: Introduction The day<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2026\/10\/07\/risk-mitigated-day-case-total-thyroidectomy-for-thyrotoxicosis-analysis-of-factors-allowing-same-day-discharge-2026\/\">Read more <span class=\"screen-reader-text\">Risk mitigated day case total thyroidectomy for thyrotoxicosis: analysis of factors allowing same day discharge (2026)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[200],"tags":[1106,228],"class_list":["post-10231","post","type-post","status-publish","format-standard","hentry","category-staff-publication","tag-1106","tag-surgery"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/10231","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=10231"}],"version-history":[{"count":1,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/10231\/revisions"}],"predecessor-version":[{"id":10232,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/10231\/revisions\/10232"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=10231"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=10231"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=10231"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}