Early discharge after total thyroidectomy: a single-center comparative study.

BACKGROUND: Total thyroidectomy is a frequently performed procedure for various thyroid diseases. Traditionally, patients undergoing this surgery are hospitalized for at least two days to monitor the onset of postoperative complications such as hypocalcemia and bleeding. This study evaluates the safety and efficacy of early discharge (on the first postoperative day) compared to the traditional protocol by analyzing postoperative outcomes and hospital readmission rates. METHODS: This is a monocentric study on 127 patients operated at the Humanitas Mater Domini Clinical Institute (Castellanza, Varese, Italy) between December 2021 and December 2024. Two groups were compared: patients operated before December 2022 following a standard protocol (Group 1, N.=41) and those discharged on the first postoperative day after December 2022 (Group 2, N.=86). Clinical variables, postoperative complications, and hospital readmission rates were analyzed. RESULTS: No significant differences were found in readmission rates, surgical complications, or postoperative symptoms between the two groups, except for an increase in mild transient hypocalcemia on the first postoperative day in Group 2 (40.7% vs. 22.0%; P=0.038). However, no patients in Group 2 required hospital readmission due to close follow-up and oral calcium supplementation. Our findings suggest that early discharge after total thyroidectomy may be safe and effective when supported by appropriate postoperative monitoring. The observed increase in transient hypocalcemia did not appear to compromise patient safety in our cohort, potentially supporting the implementation of early discharge protocols to optimize hospital resources. CONCLUSIONS: In conclusion, early discharge on the first postoperative day after total thyroidectomy appears to be a feasible option when protocols are patient-shared and context-specific. Future research is warranted to further explore risk stratification, structured post-discharge support, economic implications, and the broader impact on patient quality of life.