美国甲状腺协会多学科共识声明：门诊甲状腺手术

原文

BACKGROUND: This multidisciplinary consensus statement aims to update the 2013 American Thyroid Association statement on outpatient thyroidectomy by refining the eligibility criteria for safe ambulatory thyroid surgery based on interval published data. Evidence-based perioperative factors essential for optimizing ambulatory care after thyroid surgery are outlined here. SUMMARY: This summary statement highlights four essential aspects for safe outpatient thyroid surgery evaluating preoperative eligibility, optimizing operative planning and techniques, implementing structured postoperative protocols, and ensuring effective preparation for and management of complications. Various factors may serve as relative contraindications to ambulatory thyroid surgery, including patient comorbidities, as well as clinical, social, procedural, and facility-related characteristics. Key operative factors include the choice of anesthesia, use of nerve monitoring, hemostasis, surgical technique, and management of the parathyroid glands. Postoperative care should include clear discharge criteria and protocols that ensure prompt identification and management of complications, including bleeding, airway compromise, and significant hypocalcemia. Ensuring patient education and fostering collaboration among nursing staff, surgeons, and anesthesiologists to develop treatment pathways are essential for the success of ambulatory thyroid surgery. They optimize the patient experience and long-term outcomes while mitigating perioperative risks. CONCLUSIONS: Ambulatory thyroid surgery can be performed safely in carefully selected and well-informed patients, provided appropriate precautionary perioperative measures are implemented to enhance communication and improve patient outcomes.