Parathyroid surgery a paradigm shifts from inpatient to a day case surgery
Apurva Sinha, Afaq Siddiqui, Raj Siddhan, Makam Kishore & V Parkinathan
Introduction: There has been an increasing trend towards outpatient and short stay surgery in UK in last 20 years. This leads to reduced costs, reduced inpatient waiting lists, increased availability of inpatient beds and has the psychological benefit of avoiding prolonged hospitalisation.We liked to evaluate the feasibility of day case and short stay surgery for parathyroid disease in our district general hospital.
Material and method: It was retrospective audit of 48 patients in our district general hospital undergoing parathyroid surgery over the period of 7 years (20002007) by a single endocrine surgeon.
Results: In our study the average hospital stay was ~1.5 days with minimal morbidity of 0.5% and no mortality rate. Most of the patients had preoperative scan with either sestamibi or ultrasound or both for pre operative localization of the gland.
Conclusion: It can seen that in our district general hospital the Parathyroid surgery can be performed with minimal morbidity with an early post operative discharge. The hospital stay can further be reduced by using focussed parathyriodectomy in our hospital after adequate preoperative localization of the gland.
In most of the regional centres there is a shifting trend to perform focussed-parathyriodectomy as a day case procedure after adequate preoperative localization of the gland for uni glandular adenoma. However, we feel that this procedure needs to be discussed and made easily available to patients in all endocrine units performing parathyroid surgery. There need to be a national consensus with clear guideline made available to surgeons performing these complex procedures, so that, more and more patients can benefit by day case surgery especially for adenoma in all units performing these operations.