Ambulatory thyroidectomy: A paradigm shift in surgical safety and patient-centered care - 22/05/26

Doi : 10.1016/j.jviscsurg.2026.04.001

Pierre Puygrenier ^a,^b, Martina Bertolami ^a,^b, Séverine Noullet ^a,^b, Gaelle Godiris-Petit ^a,^b, Ariola Hasani ^a,^b, Sebastien Gaujoux ^a,^b,^c, Fabrice Menegaux ^a,^b,^c, Nathalie Chereau ^a,^b,^c,⁎

^a Department of General, Visceral, and Endocrine Surgery, Pitié-Salpêtrière Hospital, AP–HP, Paris, France

^b Sorbonne University, Paris, France

^c Groupe de Recherche Clinique No 16 Thyroid Tumors, Paris, France

^⁎ Corresponding author. Department of General, Visceral, and Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne University, AP–HP, 47-83, avenue de l’Hôpital, 75013 Paris, France. Department of General, Visceral, and Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne University, AP–HP 47-83, avenue de l’Hôpital Paris 75013 France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 22 May 2026

Summary

Introduction

Despite longstanding concerns regarding life-threatening postoperative complications such as cervical hematoma, recent guidelines endorse ambulatory thyroidectomy as a safe and feasible option when performed under strict selection and monitoring. This study evaluated the safety and feasibility of ambulatory thyroidectomy in a high-volume endocrine surgery center.

Methods

All patients undergoing ambulatory thyroidectomy between May 1st, 2018, and December 31st, 2024 were retrospectively analyzed. Studied outcomes included hematoma, hypocalcemia, recurrent laryngeal nerve (RLN) injury, infection, and unplanned admission. One-step total thyroidectomy was not eligible for ambulatory care.

Results

A total of 3047 adult patients (77% female; mean age 48.5 ± 14 years) were included: 86% underwent lobectomy, 12% completion thyroidectomy, and 2% isthmectomy. In all, 954 (31%) were performed for malignant diseases. The proportion of ambulatory thyroidectomies among all partial thyroidectomy procedures increased from 7% in 2018 to 32% in 2024. Complication rates were low: hematoma (0.8%), including those requiring reoperation (19/23; 82.6%), transient RLN palsy (1.9%), symptomatic hypocalcemia (1.1%), permanent hypoparathyroidism (0.3%), and wound infection (0.2%).

Conclusion

Ambulatory thyroidectomy can be safely integrated into routine surgical practice when conducted within a structured perioperative pathway emphasizing meticulous patient selection, extended postoperative observation, and comprehensive patient education.

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Keywords : Outpatient thyroidectomy, Ambulatory thyroid surgery, Postoperative complications, Cervical hematoma, Recurrent laryngeal nerve palsy, Hypocalcemia