Thyroid Surgery in the Elderly: A Comparative Experience of 400 Patients From an Italian University Hospital

Canonico, Silvestro; Pellino, Gianluca; Pameggiani, Domenico; Sciaudone, Guido; Candilio, Giuseppe; Fatico, G. Serena De; Landino, Isabella; Marcellinaro, Rosa; Rocco, Federica; Selvaggi, Lucio; Parmeggiani, U; Selvaggi, Francesco

doi:10.9738/intsurg-d-14-00030.1

Cited by 19 publications

(5 citation statements)

References 17 publications

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“…While many studies show a similar increase in the incidence of RLN injury in older populations, the findings are not always uniform. For instance, Canonico et al 17 and Schwartz et al 18 reported nonstatistically significant increased rates of permanent and temporary RLN paralysis among patients aged 65 and 75 years, respectively. However, Sosa et al 1 found statistically significant increases in surgery-specific complications, including RLN injury and hypoparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

Age‐Related Trends of Patients Undergoing Thyroidectomy: Analysis of US Inpatient Data from 2005 to 2013

Echanique

Govindan

Mohamed

et al. 2019

Otolaryngol.--head neck surg.

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Objectives As the country ages, thyroidectomies can be expected to be performed more frequently among the elderly. In this study, we stratified patients by age to explore demographics and complications of patients undergoing thyroidectomy. Study Design Retrospective study with a national database. Setting Nationwide Inpatient Sample. Subjects and Methods A total of 414,079 thyroidectomy cases from 2005 to 2013 were identified. Complications, outcomes, demographics, length of stay, and hospital charges were evaluated among patients and stratified by age into 4 cohorts: younger (<65 years), advanced age (65-74 years), elderly (75-84 years), and superelderly (≥85 years). Results Of 414,079 thyroidectomy cases identified, patients aged <65 years accounted for 75.6% of cases, while those aged 65-74, 75-84, and ≥85 years accounted for 16.3%, 7.2%, and 0.9%, respectively (P < .001). There was a significant difference in length of stay, total hospital charges, and mortality throughout the different age groups (P < .001), all trending upward with advancing age. In the aging population, incidence of recurrent laryngeal nerve injury, transfusion of erythrocytes, and acute cardiac complications increased with increasing age (P < .001), while hypoparathyroidism decreased with age ≥65 but ≤85 years (P < .001). Patients aged ≥75 years had increased odds of mortality as compared with their younger counterparts (P < .001). Conclusion This study utilized a national database to describe and elucidate trends in older populations undergoing thyroidectomy. Thyroid-related complications, including blood transfusion and recurrent laryngeal nerve injury, increased with increasing patient age. This information will help to guide pre- and postoperative care for aging patients undergoing thyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Age‐Related Trends of Patients Undergoing Thyroidectomy: Analysis of US Inpatient Data from 2005 to 2013

Echanique

Govindan

Mohamed

et al. 2019

Otolaryngol.--head neck surg.

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“…Similarly, Diaconescu et al [12] also reported that despite some additional risks related to comorbidities in patients over 65 years, patients may benefit of all types of conservative or radical thyroidectomies. Canonico et al [13] also reported that age did not increase the incidence of worse outcomes in patients who underwent thyroid surgery. On the other hand, in a population-based study on patients who underwent surgery for thyroid neoplasms, the rate of general postoperative complications was 6.5% and the rate of thyroid surgery-specific complications was 12.3%.…”

Section: Discussionmentioning

confidence: 93%

Outcomes of thyroid operations in patients of different age groups

Çiftçi

Tiryaki

2021

The European Research Journal

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Objectives: To determine the effects of age on preoperative findings and on outcomes of thyroid surgeries. Methods: In this retrospective study, we analyzed the demographics, surgical and pathological data, postoperative complications and biochemical results including calcium, phosphorus and parathyroid hormone (PTH) levels of patients who undertaken thyroid operations. Results: Totally 288 consecutive patients operated for thyroid diseases were included in the study. The patients were grouped regarding their ages as patients in the 3 rd decade (n = 26), 4 th decade (n = 60), 5 th decade (n = 81), 6 th decade (n = 77) and 7 th decade (n = 44). There was not any significant difference between groups regarding the preoperative diagnoses (p = 0.09). With an advance in age, the presence of multiple nodules in preoperative period was increasing (p = 0.015). On postoperative period, the pathological diagnosis was malignant in 46 (15.9%) patients. There was not any significant difference between groups regarding the tumor type (p = 0.80). The most common tumor type was papillary carcinoma in all age groups. Postoperative complications were determined in 68 (23.6%) patients and there was not any significant difference regarding the presence of postoperative complications in all age groups (p = 0.26). Conclusions: In conclusion, there was not any significant difference regarding postoperative outcomes in patients operated for thyroid diseases who were in the different decades of their lives. We can suggest that, thyroid surgeries are as safe in elderly patients as in younger patients.

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“…In our practice, we currently consider and propose prophylactic placement of NPWT to patients with at least two accepted predictors of SSI [3,17,21,28,29], or when there is a break in perioperative prophylactic measures [21]. Patients receiving steroids, frail (in the elderly with comorbidities-who are not excluded from major procedures in current practice [7,[93][94][95] ) or immunodepressed patients, and young patients suffering from IBD [7][8][9] are the ideal candidates to preventive NPWT after Colorectal surgery. It can be predicted that the use of preventive NPWT is cost-effective and well accepted in these patients.…”

Section: Clinical Trials On Preventive Npwt In Colorectal Surgerymentioning

confidence: 99%

Prophylactic negative pressure wound therapy in colorectal surgery. Effects on surgical site events: current status and call to action

et al. 2015

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Surgical site events, including surgical site infections (SSI), represent a major problem in general surgery. SSI are responsible of nuisance for patients, and can lead to important complications and disability, often needing prolonged postoperative stay with specific treatment and recovery in Intensive Care Units. These justify the higher costs due to SSI. Despite the growing body of evidence concerning SSI in general surgery, literature dealing with SSI after colorectal surgery is scarce, reflecting in suboptimal perception of such a relevant issue by colorectal surgeons and health authorities in Italy, though colorectal surgery is associated with higher rates of SSI. The best strategy for reducing the impact of SSI on costs of care and patients quality of life would be the development of a preventive bundle, similar to that adopted in the US through the colorectal section of the National Surgery Quality Improvement Project of the American College of Surgeons (ACS-NSQIP). This policy has been showed to significantly reduce the rates of SSI. In this scenario, incisional negative pressure wound therapy (NPWT) is likely to play a pivotal role. We herein reviewed the literature to report on the current status of preventive NPWT on surgical wounds of patients undergoing colorectal procedures with primary wound closure, suggesting evidence-based measures to reduce the impact of SSI, and to contain the costs associated with conventional NPWT devices by means of newer available technologies. Some explicative real life cases are presented.

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Thyroid Surgery in the Elderly: A Comparative Experience of 400 Patients From an Italian University Hospital

Cited by 19 publications

References 17 publications

Age‐Related Trends of Patients Undergoing Thyroidectomy: Analysis of US Inpatient Data from 2005 to 2013

Age‐Related Trends of Patients Undergoing Thyroidectomy: Analysis of US Inpatient Data from 2005 to 2013

Outcomes of thyroid operations in patients of different age groups

Prophylactic negative pressure wound therapy in colorectal surgery. Effects on surgical site events: current status and call to action

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