Thyroidectomy is the partial or complete removal of the thyroid gland in order to treat thyroid disorders, such as benign enlargement (goiter), overactive thyroid (hypothyroidism) or cancerous lesions.

Conventionally, the surgery setup for thyroidectomy has been inpatient, but seven years ago outpatient surgeries were started in the academic hospitals and spread to more centers around the world. Inpatient procedures are generally costly and time-consuming, and they have longer turnover times.

With the current trend of population growth and increased life expectancy, there is a need to reduce the cost of healthcare and to maximize the use of medical resources and professionals. One of the strategies to increase operating room (OR) utilization is to dedicate an outpatient OR for less complicated cases.

Many previously inpatient procedures — such as tonsillectomies and cholecystectomies — are now routine outpatient procedures these days. Some of the advantages of the outpatient OR, include increased operative time efficiency and OR utilization due to good patient selection criteria and more efficient staffing.

This is also the case with thyroid and parathyroid procedures — historically considered as inpatient procedures due to their potential complications, such as laryngeal nerve and airway damage or hematomas. The incidence of thyroid disorders, including the cancer cases, has been constantly increasing the past few years in many different countries.

Thyroid surgery is normally performed with low morbidity and no mortality. However, although this surgery is relatively easy and doable in a short time, some potentially lethal complications could occur. This has created a debate against shorter hospital stay after this surgery.

A number of recent studies have suggested that for a properly-selected group of patients, an outpatient setup of surgery could be more efficient yet feasible and safe, with a significantly lower turnover times as compared to that of the inpatient setup. This could benefit both healthcare professionals and the patients through cost savings and greater hospital OR utility.

In general, there is a trend to develop novel surgical techniques to make it possible to turn more operations into outpatient procedures. Therefore, there has been a constant increase in the number of outpatient operations in many different countries in recent years.

In a comparative cross-sectional analysis of the National Survey of Ambulatory Surgery (NSAS) and Nationwide Inpatient Sample (NIS) databases in the time period of 1996-2006, there was a modest and pronounced increase in inpatient and outpatient thyroidectomies performed in the United States.

The total number of thyroidectomy cases increased 39 percent, while the number of outpatient procedures increased 61 percent as compared to an increase of 30 percent for the inpatient surgeries during the study period.

This trend also demonstrated an economic impact such that the inflation-adjusted per capita charges for inpatient thyroidectomies was $22,537 as compared that of the outpatient cost of $7,222.