SRS331 - Implementation of a day case hemithyroidectomy pathway

Background Thyroidectomy has traditionally required inpatient admission secondary to concerns of postoperative complications of bleeding, airway obstruction, and hypocalcaemia. However, increased pressures on healthcare resources have mandated re-evaluation of surgical pathways. British Association of Day Surgery (BADS) considers day case thyroidectomies a safe procedure. In the last BAETs audit only 5.5% of all UK thyroid surgeries were undertaken as day case between 2010–2015. This single-hospital study aimed to review current practice, post-operative complications, and describe a standardised protocol by which day case hemithyroidectomy can be implemented safely. Methods This single-centre retrospective study included all thyroid and parathyroid procedures performed between February 2023 and December 2024 in Portsmouth University Hospitals. Results A total of 456 thyroid and parathyroid operations performed between February 2023 and December 2024, 6 (1.32%) experienced postoperative haematomas with only 4/6 requiring a return to theatres. 2/284 were following hemithyroidectomy (0.85%) and 4/172 after parathyroidectomy (2.33%). There was no mortality reported. Of the remaining patients who had no haematomas, 5% of hemithyroidectomy patients would have met the day-case criteria. Conclusions Our single-centre results suggest that day-case hemithyroidectomy is safe and will contribute to improved bed utilisation, cost reduction, and enhanced patient satisfaction without compromising safety. A two-part day case hemithyroidectomy protocol was developed. An additional prospective evaluation will be carried out to validate the efficacy of the protocol suggested in real clinical practice.