OUTPATIENT PARATHYROID SURGERY.OPEN ROAD TO THE FUTURE

AUTHORS:
D. Morales (Malaga, Spain) , S. Rocio (Malaga, Spain) , J.L. Fernandez (Malaga, Spain) , G. Plata (Malaga, Spain) , M.D. Dominguez (Malaga, Spain) , L. Perez (Malaga, Spain) , A. Adarve (Malaga, Spain) , L.T. Ocaña (Malaga, Spain)
Background:
Outpatient surgery (OS) is consolidated in many pathologies, but there are still controversies regarding endocrine surgery. The objective of this study was to present the results about OS parathyroid surgery program in a reference hospital.
Methods:
The patient selection criteria included those patients with a diagnosis of primary hyperparathyroidism (HPT1º) due to parathyroid adenoma, with two positive localization tests, ages between 18 and 80 years, with an ASA I, II or III pre-anesthetic assessment, who live less than an hour from the hospital center, have a contact telephone number and are accompanied.Histological confirmation is performed through intraoperative biopsy, as well as PTH determinations according to the Miami criteria. After surgery, patients move to the post-anesthetic recovery and readaptation area. If tolerance is correct, postoperative pain is controlled and there is no evidence of clinical hypocalcemia, they are discharged.Next morning a phone call is made.
Results:
From March 2019 to March 2023, 143 patients with HPT1º have been operated and 78 have been performed as OS, 11 were male and 67 female, mean age of 60 7 years. The average surgery time was 3815 minutes. The time spent in the unit from admission in the early morning until discharge was 9.5 2 hours, with no mortality or readmission. Regarding complications, only one case of symptomatic hypocalcemia at 48 hours and a wound seroma.
Conclusions:
OS HPT1º surgery, with correct patient selection and in expert teams, can be performed in outpatient surgery with complete safety.