{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:51:28Z","timestamp":1790790688912,"version":"4.1.0"},"reference-count":71,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,3,13]],"date-time":"2006-03-13T00:00:00Z","timestamp":1142208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Critical appraisal of safety, feasibility, and economic impact of thyroidectomy procedures using local (LA) or general anesthesia (GA) is performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients undergoing thyroidectomy procedures were selected from a prospective database from January 1996 to June 2003 of a single\u2010surgeon practice at a tertiary center. Statistical analyses determined differences in patient characteristics, outcomes, operative data, and length of stay (LOS) between groups. A cohort of consecutive patients treated in 2002\u20132003 by all endocrine surgeons at the institution was selected for cost analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,194 patients underwent thyroidectomy, the majority using LA (n = 939) and outpatient surgery (65%). Female gender (76%), body mass index \u226530\u00a0kg\/m<jats:sup>2<\/jats:sup> (29%), median age (49 years), and cancer diagnosis (45%) were similar between groups. Extent of thyroidectomy (59% total) and concomitant parathyroidectomy (13%) were similarly performed. GA was more commonly utilized for patients with comorbidity [15% vs. 10%, Anesthesia Society of America (ASA) \u22653; <jats:italic>P<\/jats:italic> &lt; 0.001], symptomatic goiter (13% vs. 7%; <jats:italic>P<\/jats:italic> = 0.004), reoperative cases (10% vs. 6%; <jats:italic>P<\/jats:italic> = 0.01), and concomitant lymphadenectomy procedures (15% vs. 3%; <jats:italic>P<\/jats:italic> &lt; 0.001). GA was associated with significant increase in LOS \u226524 hours (17 % vs. 4%) or overnight observation (49 % vs. 14%), <jats:italic>P<\/jats:italic> &lt; 0.001. Operative room utilization was significantly associated with type of anesthesia (180\u00a0min vs. 120\u00a0min, GA vs. LA, <jats:italic>P<\/jats:italic> &lt;. 001) and impacted to a lesser degree by surgeon operative time (89\u00a0minutes vs. 76\u00a0minutes, GA vs. LA; <jats:italic>P<\/jats:italic> =. 089). Overall morbidity rates were similar between groups (GA 5.8 % vs. LA 3.2%). The actual total cost (ATC) per case for GA was 48% higher than for LA and 30% higher than the ATC for all procedures (<jats:italic>P<\/jats:italic> = 0.006), with the combined weighted average impacted by more LA cases (n = 217 vs. 85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data from a large, unselected group of thyroidectomy patients suggest LA results in similar outcomes and morbidity rates to GA. It is likely that associated LA costs are lower.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0384-3","type":"journal-article","created":{"date-parts":[[2006,3,17]],"date-time":"2006-03-17T17:01:18Z","timestamp":1142614878000},"page":"813-824","source":"Crossref","is-referenced-by-count":62,"title":["Thyroidectomy Using Monitored Local or Conventional General Anesthesia: An Analysis of Outpatient Surgery, Outcome and Cost in 1,194 Consecutive Cases"],"prefix":"10.1002","volume":"30","author":[{"given":"Kathryn","family":"Spanknebel","sequence":"first","affiliation":[{"name":"Division of General Surgery, The New York Thyroid Center College of Physicians and Surgeons, Columbia University 177 Fort Washington Avenue, MHB\u20107SK 10032 New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Chabot","sequence":"additional","affiliation":[{"name":"Division of General Surgery, The New York Thyroid Center College of Physicians and Surgeons, 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