Post operative hypocalcemia poses significant resistance to early discharge of total thyroidectomised patients. Our institute implemented a new protocol to give empirical calcium and vitamin D supplements since Jan 2012 to prevent symptomatic hypocalcemia and facilitate early discharge. 75 (88.24%) out of 85 eligible cases did not have significant or symptomatic hypocalcemia and can be discharged by within 1 day with only two (2.67%) patients being readmitted electively for significant hypocalcemia on follow up. While in the selected subgroup which excludes cancer cases, concomitant primary hyperparathyroidism and retrosternal goitres to be considered for day surgery, 58 (95.08%) out of 61 were able to be discharged on first post operative day without symptoms. All those who could not be discharged reported symptoms by at most 15 h. Within this group we had not excluded reoperation and controlled Graves disease cases, which previous series considered high risk with respect to day surgery and were excluded. Our results confirmed in well selected patient groups with routine calcium supplements and early follow up, discharging total thyroidectomised patients is feasible and safe within 24 h.
27 Apr - 01 May 2013
European Society of Endocrinology