Many surgical procedures are nowadays conducted under same day-discharge surgery programs without compromising quality of care or patient safety. Despite this trend, certain specialized areas, like neck-endocrine surgery, show resistance due to his potential dreadful complications.

We conducted an analysis following the implementation of a day-case surgery pathway. Bilateral neck exploration, combined total thyroidectomy, reintervention, anticoagulation or severe comorbidities were main exclusion criteria. Social aspects were also taken into account. Following surgery patients are monitored for at least 6 hours. If no clinical complications arise, including hematoma, decrease in calcium levels by 2,5mg/dL from the preoperative value, or PTH<15 pg/mL, they are discharged with an informational booklet, prophylactic calcium 500mg/8h, and a follow-up appointment with new blood tests 48 hours after surgery.

Since 2015,132 cases were performed; 20 were excluded from the beginning based on technical aspects as said before. We accomplished 81 same-day discharge surgeries (72,32%); 31 do not fulfill discharge criteria after surgery, mainly due to a decrease in PTH<15pg/mL. No patient developed hematoma. One patient re-entered with severe hypocalcemia 24 hours after surgery. Average preoperative PTH values were 110.91pg/mL, while postoperative ones averaged 28,21pg/mL. Average percentage decrease was 68.71%. Mean PTH values at 6 months were 45.13pg/mL. Calcium levels at 6 months showed average values of 9,63mg/dL. Only one patient showed persistence and was subsequently operated on.

Patient selection is critically important when establishing day-case surgery programs. Postoperative close monitoring and prophylactic treatment shape the outcome of these programs too, underscoring their quality and the possibility of widespread application.