Overnight total thyroidectomy: a safe management

Introduction: Rapid discharge protocols have gained progressive popularity even in thyroid surgery due to the superimposable risks of complications compared to inpatient management and for the subsequent increased surgical volume. The aim of this study is to evaluate results, benefits and complications’ rates of a rapid discharge in postoperative day 1 (POD1 - overnight thyroidectomy) among patients submitted to total thyroidectomy at our surgical clinic. Materials and methods: Single centre retrospective analysis of 729 patients submitted to total thyroidectomy between 2016 and 2024; 402 patients who are scheduled for discharge on POD 1 and 327 patients discharged after a minimum of 72 hours observation (POD 3). Data concerning postoperative complications (POC) at 24 hours, 10 and 30 days were collected. Patients’ satisfaction about the rapid discharge protocol was also registered. Results: We registered no significative differences between incidence of complications at 24h, 10-days or 30-days re-evaluations in POD1 and POD3 groups. Graves’ Disease represents the main context in which early postoperative (24h) and overall complications occurred. The 94.6% of POD1 patients reported a global satisfaction in the rapid discharge scenario. Conclusions: POD1 patients are not exposed to additional postoperative risk with overnight thyroidectomy following total thyroidectomy, given accurate patient selection. Early and overall complications are more frequently observed in patients with Graves' disease. Overnight thyroidectomy, combined with thorough perioperative patient education, received widespread appreciation among our surgical cohort.