© Gland Surgery. All rights reserved. Gland Surg 2017;6(4):292-301 gs.amegroups.com Introduction The United States healthcare system is under increased scrutiny to reduce cost without undermining the quality of patient care. Patient comfort and economic considerations have made a significant impact on the evolving trend towards ambulatory surgery. Along with the advancements in postoperative care and anesthesia, more procedures are performed on an outpatient same-day basis (1). Recently, the American Thyroid Association published an interdisciplinary consensus statement on Original Article Safety of same-day thyroidectomy: meta-analysis and systematic review Helmi Khadra 1 , Salah Mohamed 1 , Adam Hauch 1 , John Carter 2 , Tian Hu 3 , Emad Kandil 1 1 Division of Endocrine and Oncologic Surgery, Department of Surgery, 2 Department of Otolaryngology, Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA, USA; 3 Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA Contributions: (I) Conception and design: E Kandil; H Khadra; (II) Administrative support: E Kandil; (III) Provision of study materials or patients: H Khadra, S Mohamed; (IV) Collection and assembly of data: H Khadra, S Mohamed; (V) Data analysis and interpretation: T Hu, A Hauch, J Carter, E Kandil, H Khadra; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Emad Kandil, MD, MBA, FACS, FACE. Edward G. Schlieder Chair in Surgical Oncology, Associate Professor of Surgery, Chief, Endocrine Surgery Section, Department of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA 70112, USA. Email: Ekandil@tulane.edu. Background: Performance of thyroid surgery as a same day surgery procedure has been a controversial topic. This study aimed to compare the safety and efficacy of outpatient thyroid surgery with inpatient thyroid surgery by meta-analysis of current literature. Methods: Articles were identifed from the following keyword searches: outpatient thyroidectomy/thyroid surgery, same day thyroidectomy/thyroid surgery. Outcomes included perioperative complications including recurrent laryngeal nerve (RLN) injury, hypocalcemia, and readmissions. Data were extracted following review of appropriate studies by authors and random effects models were used. Results: 34 potentially relevant publications were identified and 14 studies fulfilled the predetermined inclusion criteria, totaling 10,478 patients, 4,565 of whom were discharged the same day following thyroid surgery. There was no difference in malignancy rate between the two groups (95% CI, 0.84–2.31; P=0.196). Inpatient group were 2.23 times (95% CI, 1.36–3.36; P=0.001) more likely to develop transient RLN injury and 2.32 times (95% CI, 1.06–5.06; P=0.034) more likely to have documented transient hypocalcemia compared to outpatients. Inpatient groups were 2.10 times (95% CI, 1.33–3.33; P=0.002) more likely to have documented other complications. The two groups also had similar readmission rates (95% CI, 0.71–1.41; P=1.000). Conclusions: Our meta-analysis suggests that discharging selective patients the same day after a thyroid surgery is as safe, feasible, and effcacious as admitting them for observation. Admitting patients after thyroid surgery is associated with higher reported risk of complications. Keywords: Outpatient thyroid surgery; same day thyroid surgery; outpatient thyroidectomy; same day thyroidectomy Submitted Nov 23, 2016. Accepted for publication Dec 01, 2016. doi: 10.21037/gs.2017.01.05 View this article at: http://dx.doi.org/10.21037/gs.2017.01.05