Shortening Postoperative Stay after Parathyroidectomy - A District General Hospital Experience
| Autor: | Christopher Backhouse, Mustafa Al-Sheikh, Matthew Fok, Sidhartha Sinha, Ijaz Ahmad |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Parathyroidectomy
medicine.medical_specialty endocrine medicine.medical_treatment lcsh:Medicine 030230 surgery surgical outcomes parathyroidectomy quality improvement head and neck surgery 03 medical and health sciences 0302 clinical medicine length of stay medicine General hospital Original Research business.industry lcsh:R lcsh:Otorhinolaryngology medicine.disease lcsh:RF1-547 Short stay surgery Surgery Otorhinolaryngology 030220 oncology & carcinogenesis Perioperative care Head and neck surgery Parathyroid surgery business Primary hyperparathyroidism Patient education short stay surgery |
| Zdroj: | International Archives of Otorhinolaryngology v.24 n.3 2020 International Archives of Otorhinolaryngology Fundação Otorrinolaringologia (FORL) instacron:FORL International Archives of Otorhinolaryngology, Volume: 24, Issue: 3, Pages: 313-318, Published: 28 AUG 2020 International Archives of Otorhinolaryngology, Vol 24, Iss 03, Pp e313-e318 (2020) |
| Popis: | Introduction Historically, concerns about complications following parathyroid surgery, such as airway compromise, bleeding and hypocalcemia, have precluded its consideration as a short-stay surgical procedure. Recent advancements in perioperative care have resulted in several publications demonstrating that parathyroidectomy can be safely performed as a short-stay procedure. Objectives The aim of the present study was to describe the process of implementing a short-stay protocol focusing on preoperative patient education and postoperative calcium management for those undergoing surgery for primary hyperparathyroidism (PHP). Method A retrospective audit of consecutive parathyroidectomies performed for PHP over the period between 2010 and 2013 was performed. A short-stay protocol (SSP) was introduced focusing on postoperative calcium management. Results were reaudited over the period between 2013 and 2015. Results Consecutive parathyroidectomies in 76 patients were included in the study. A total of 42 patients underwent parathyroidectomy prior to the introduction of the protocol. A total of 26.2% of these patients were symptomatic from hypercalcemia. A total of 40 out of 42 (95.2%) patients had a biochemical cure. A total of 36 out of 42 (85.7%) cases were due to parathyroid adenomas. A total of 34 patients underwent surgery following the introduction of the protocol. A total of 13 out of 34 (38.2%) of the patients had symptomatic hypercalcemia. A total of 33 out of 34 (97.1%) had a biochemical cure. A total of 32 out of 34 (94.1%) cases were due to parathyroid adenomas.The length of stay decreased from a median of 3 days (range 2–9 days; mean 3.32) preprotocol to a median of 2 days (range 2–3 days; mean 2.16) postprotocol (p Conclusions The postoperative length of stay after parathyroidectomy for PHP can be safely reduced through patient education and by rationalizing postoperative calcium management without adversely affecting outcomes. |
| Databáze: | OpenAIRE |
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