Harvard Medical Student Review
Thyroidectomy in an Outpatient versus Inpatient Setting
By Syed Hasham Ali, Zoha Syed, Abdullah Ahmad and 3 others.
Abstract
Objectives
This updated meta-analysis evaluates the clinical and economic outcomes of outpatient versus inpatient thyroidectomy Data Sources: PubMed/Medline, Cochrane Library, Embase, Scopus, and Web of Science were searched from the inception of databases until 18 May 2025. Review Methods: This systematic review and meta-analysis followed PRISMA, MOOSE, and Cochrane guidelines. Studies comparing outpatient and inpatient thyroidectomy reporting relevant outcomes were included. Data was extracted using standardized tools. Primary outcomes included procedure types, complication rates, readmissions, and reoperations. Costs were descriptively analysed in April 2025 USD. Meta-analyses used random-effects models, and heterogeneity was assessed via I², subgroup analysis, and meta-regression. Publication bias was evaluated with funnel plots.
Results
26 studies (n=291,075) were included. Outpatients were more likely to undergo hemithyroidectomy (RR 1.29) and less likely to need neck dissection (RR 0.45). They had lower rates of recurrent laryngeal nerve injury/hoarseness (RR 0.59), neck hematoma (RR 0.58), hypocalcemia (RR 0.52), and total complications after total thyroidectomy (RR 0.52). Direct hospital charges were US $850-2800 lower per case.