Abstract
Aim: The prevalence of benign and malignant thyroid diseases increases with age. Since the population continues to age, the necessity and feasibility of thyroid surgery in the elderly has become more questionable. The aim of this study is to evaluate thyroid surgery and determine whether thyroidectomy is a safe option in the elderly population, by comparing with younger counterparts.
Methods: The data of 471 consecutive patients (370 females, 101 males) with benign or malignant thyroid disorders who underwent thyroid surgery between June 2016 and May 2018 were evaluated retrospectively. The patients were divided into two groups, as younger (age <65) and elderly group (age ≥65). Both groups were compared in terms of indications, post-surgical complications, and histopathological results. All statistical tests were performed using SPSS, version 18.0, software (SPSS Inc., Chicago, IL).
Results: Thyroid surgery in the elderly patients showed similarities compared to younger patients in terms of indications and most of the postoperative complications (P>0.05 for each). However, some differences were seen such as increased postoperative hemorrhage and length of hospital stay in favor of the elderly (P=0.035 and P<0.001, respectively).The incidence of malignant disease was found to be slightly higher in the younger group compared to the elderly (42.96% vs. 31.81%, respectively, P=0.095). Surgery-related death was not observed.
Conclusion: Our experience confirms that successful results can be achieved with low morbidity in experienced hands if careful and close monitoring of co-morbid conditions is provided in elderly patients.
References
- 1. Echanique KA, Govindan A, Mohamed OM, Sylvester M, Baredes S, Yu-Lan Ying M, et al. Age-Related Trends of Patients Undergoing Thyroidectomy: Analysis of US Inpatient Data from 2005 to 2013. Otolaryngol Head Neck Surg. 2019;160(3):457-64.
- 2. Higgins K. Thyroid Disorders in the Elderly: An Overall Summary. Clin Geriatr Med. 2018;34(2):259-77.
- 3. Gervasi R, Orlando G, Lerose MA, Amato B, Docimo G, Zeppa P, et al. Thyroid surgery in geriatric patients: a literature review. BMC Surg. 2012;12(Supp1):S16.
- 4. Park HS, Jung CK, Lee SH, Chae BJ, Lim DJ, Park WC, et al. Clinicopathologic characteristics and surgical outcomes of elderly patients with thyroid cancer. Jpn J Clin Oncol. 2014;44:1045–51.
- 5. Raffaelli M, Bellanton R, Princi P, De Crea C, Rossi E D, Fadda G, et al. Surgical treatment of thyroid diseases in elderly patients. Am J Surg. 2010;200(4):467–72.
- 6. McIntire JB, McCammon S, Mong ER. Endocrine Surgery in the Geriatric Population. Otolaryngol Clin North Am. 2018;51(4):753-8.
- 7. Grogan RH, Mitmaker EJ, Hwang J, Gosnell JE, Duh QY, Clark OH, et al. A population-based prospective cohort study of complications after thyroidectomy in the elderly. J Clin Endocrinol Metabol. 2012;97(5):1645-53.
- 8. Tartaglia F, Russo G, Sgueglia M, Blasi S, Tortorelli G, Tromba L, et al. Total thyroidectomy in geriatric patients: a retrospective study. Int J Surg. 2014;12(Suppl 2):S33–6.
- 9. Passler C, Avanessian R, Kaczirek K, Prager G, Scheuba C, Niederle B. Thyroid surgery in the geriatric patient. Arch Surg. 2002;137(11):1243–8.
- 10. American Thyroid Association. Older patients and thyroid disease. https://www.thyroid.org/thyroid-disease-older-patient/. Accessed June 2017.
- 11. Miccoli P, Iacconi P, Cecchini GM, Caldarelli F, Ricci E, Berti P, et al. Thyroid surgery in patients aged over 80 years. Acta Chir Belg. 1994;94(4):222-3.
- 12. Seybt MW, Khichi S, Terris DJ. Geriatric thyroidectomy: safety of thyroid surgery in an aging population. Arch Otolaryngol Head Neck Surg. 2009;135(10):1041–4.
- 13. Joseph KR, Edirimanne S, Eslick GD. Thyroidectomy for thyroid cancer in the elderly: A meta-analysis. Eur J Surg Oncol. 2019;45(3):310-7.
- 14. Sosa JA, Mehta PJ, Wang TS, Boudourakis L, Roman SA. A population-based study of outcomes from thyroidectomy in aging Americans: at what cost? J Am Coll Surg. 2008;206:1097-105.
Abstract
Amaç: Benign ve malign tiroid hastalıklarının prevalansı yaşla birlikte artar. Nüfus yaşlanmaya devam ettiğinden, yaşlılarda tiroid cerrahisinin gerekliliği ve uygulanabilirliği daha tartışmalı hale gelmiştir. Bu çalışmanın amacı, yaşlı hastalarda tiroid cerrahisini değerlendirmek ve genç hastalarla karşılaştırıldığında tiroidektominin yaşlı popülasyonda güvenli bir seçenek olup olmadığını belirlemektir.
Yöntemler: Haziran 2016-Mayıs 2018 tarihleri arasında benign veya malign tiroid hastalığı olan ve tiroid cerrahisi geçiren 471 ardışık hastanın (370 kadın, 101 erkek) verileri retrospektif olarak incelendi. Hastalar genç grup (yaş <65) ve yaşlı grup (yaş ≥65) olmak üzere iki gruba ayrıldı. Her iki grup endikasyonlar, cerrahi sonrası komplikasyonlar ve histopatolojik sonuçlar açısından karşılaştırıldı. Tüm istatistiksel testler SPSS, sürüm 18,0, yazılım (SPSS Inc., Chicago, IL) kullanılarak yapıldı.
Bulgular: Yaşlı hastalarda tiroid cerrahisi, endikasyon ve postoperatif komplikasyonların çoğu açısından genç hastalara göre benzerlikler gösterdi (P>0,05). Bununla birlikte, artmış postoperatif kanama ve hastanede kalış süresi gibi yaşlılar lehine bazı farklılıklar görüldü (sırasıyla P=0,035 ve P<0,001). Malign hastalık insidansı genç grupta yaşlılara göre biraz daha yüksek bulundu (sırasıyla %42,96 ve %31,81, P=0,095). Cerrahi ile ilişkili ölüm gözlenmedi.
Sonuç: Deneyimlerimiz, yaşlı hastalarda ko-morbid durumların dikkatli ve yakından izlenmesi durumunda, deneyimli ellerde düşük morbidite ile başarılı sonuçların elde edilebileceğini doğrulamaktadır.
References
- 1. Echanique KA, Govindan A, Mohamed OM, Sylvester M, Baredes S, Yu-Lan Ying M, et al. Age-Related Trends of Patients Undergoing Thyroidectomy: Analysis of US Inpatient Data from 2005 to 2013. Otolaryngol Head Neck Surg. 2019;160(3):457-64.
- 2. Higgins K. Thyroid Disorders in the Elderly: An Overall Summary. Clin Geriatr Med. 2018;34(2):259-77.
- 3. Gervasi R, Orlando G, Lerose MA, Amato B, Docimo G, Zeppa P, et al. Thyroid surgery in geriatric patients: a literature review. BMC Surg. 2012;12(Supp1):S16.
- 4. Park HS, Jung CK, Lee SH, Chae BJ, Lim DJ, Park WC, et al. Clinicopathologic characteristics and surgical outcomes of elderly patients with thyroid cancer. Jpn J Clin Oncol. 2014;44:1045–51.
- 5. Raffaelli M, Bellanton R, Princi P, De Crea C, Rossi E D, Fadda G, et al. Surgical treatment of thyroid diseases in elderly patients. Am J Surg. 2010;200(4):467–72.
- 6. McIntire JB, McCammon S, Mong ER. Endocrine Surgery in the Geriatric Population. Otolaryngol Clin North Am. 2018;51(4):753-8.
- 7. Grogan RH, Mitmaker EJ, Hwang J, Gosnell JE, Duh QY, Clark OH, et al. A population-based prospective cohort study of complications after thyroidectomy in the elderly. J Clin Endocrinol Metabol. 2012;97(5):1645-53.
- 8. Tartaglia F, Russo G, Sgueglia M, Blasi S, Tortorelli G, Tromba L, et al. Total thyroidectomy in geriatric patients: a retrospective study. Int J Surg. 2014;12(Suppl 2):S33–6.
- 9. Passler C, Avanessian R, Kaczirek K, Prager G, Scheuba C, Niederle B. Thyroid surgery in the geriatric patient. Arch Surg. 2002;137(11):1243–8.
- 10. American Thyroid Association. Older patients and thyroid disease. https://www.thyroid.org/thyroid-disease-older-patient/. Accessed June 2017.
- 11. Miccoli P, Iacconi P, Cecchini GM, Caldarelli F, Ricci E, Berti P, et al. Thyroid surgery in patients aged over 80 years. Acta Chir Belg. 1994;94(4):222-3.
- 12. Seybt MW, Khichi S, Terris DJ. Geriatric thyroidectomy: safety of thyroid surgery in an aging population. Arch Otolaryngol Head Neck Surg. 2009;135(10):1041–4.
- 13. Joseph KR, Edirimanne S, Eslick GD. Thyroidectomy for thyroid cancer in the elderly: A meta-analysis. Eur J Surg Oncol. 2019;45(3):310-7.
- 14. Sosa JA, Mehta PJ, Wang TS, Boudourakis L, Roman SA. A population-based study of outcomes from thyroidectomy in aging Americans: at what cost? J Am Coll Surg. 2008;206:1097-105.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery |
| Journal Section | Research article |
| Authors | |
| Publication Date | October 1, 2020 |
| Published in Issue | Year 2020 Volume: 4 Issue: 10 |
