Surgical treatment of thyroid diseases in elderly patients

• Published in: The American journal of surgery 2010-10, Vol.200 (4), p.467-472
• Main Authors: Raffaelli, Marco, M.D, Bellantone, Rocco, M.D, Princi, Pietro, M.D, De Crea, Carmela, M.D, Rossi, Esther D., M.D, Fadda, Guido, M.D, Lombardi, Celestino P., M.D
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; Benign; Biological and medical sciences; Biopsy, Fine-Needle; Cancer therapies; Diagnosis, Differential; Elderly patients; Endocrinopathies; Female; Follow-Up Studies; General aspects; Geriatric surgery; Geriatrics; Goiter; Histology; Humans; Hyperthyroidism; Intensive care; Iodine; Italy - epidemiology; Larynx; Male; Medical records; Medical sciences; Mortality; Motility; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Older people; Patients; Population; Retrospective Studies; Risk Factors; Severity of Illness Index; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of endocrine glands; Survival Rate - trends; Thyroid; Thyroid cancer; Thyroid carcinoma; Thyroid diseases; Thyroid Diseases - diagnosis; Thyroid Diseases - mortality; Thyroid Diseases - surgery; Thyroid surgery; Thyroid. Thyroid axis (diseases); Thyroidectomy; Thyroidectomy - methods; Toxic goiter; Treatment Outcome
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2009.12.020

Abstract Background We evaluated the safety of thyroid surgery in elderly patients, in whom surgical procedures usually are considered more hazardous than in younger patients. Methods The medical records of all the patients who were aged 70 years or older who had undergone thyroid surgery between January 1998 and June 2008 were reviewed. Results A total of 320 patients were included. The preoperative diagnosis was multinodular goiter in 171 cases, toxic goiter in 59 cases, suspicious or indeterminate thyroid nodule in 60 cases, and thyroid carcinoma in 30 patients. Total thyroidectomy was performed in 283 patients, thyroid lobectomy in 15 patients, and a completion thyroidectomy was performed in 22 patients. The final histology showed thyroid cancer in 86 patients and benign disease in 234. Conclusions Thyroid surgery in patients aged 70 years or older is safe and the relatively high rate of thyroid carcinoma and toxic goiter may justify an aggressive approach.