Indications to total thyroidectomy for multinodular goiter in old patients

biomed - Puzziello A , Lucisano Am , Gervasi R , Siani C , Lerose Ma , Orlando G , Innaro N , Vescioe G , Sacco , Sacco R

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Publié par	biomed
Publié le	01 janvier 2011
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Puzzielloet al.BMC Geriatrics2011,11(Suppl 1):A49 http://www.biomedcentral.com/14712318/11/S1/A49

M E E T I N GA B S T R A C T

Open Access

Indications to total thyroidectomy for multinodular goiter in old patients * A Puzziello , AM Lucisano, R Gervasi, C Siani, MA Lerose, G Orlando, N Innaro, G Vescioe, R Sacco FromXXIII Annual Meeting of the Italian Society of Geriatric Surgery Lecce, Italy. 24 December 2010

Background In Western society, the percentage of elderly people is continually growing. The prevalence of goiter increases with the age and it is estimated that 90% of women over 60 years old and 60% of men over 80 years old have a relief of thyroid nodules. This has great importance for these patients, because the incidence of malignant trans formation is higher than younger ones and these are often tumor very aggressive patterns. If thyroidectomy is indicated for patients with suspected neoplasm and severe obstructive symptoms, their surgery should not be delayed since a late urgent operation could raise morbidity and mortality risk. The main indications for young patients are due to obstructive and metabolic causes over and above suspected cancer. Total thyroidectomy is considered by many authors as the treatment of choice.

Materials and methods 75 elderly patients were submitted to thyroidectomy. The indications were metabolic (42.6%), obstructive (32%) and for suspected cancer (25.4%).

Results The most frequent complications observed with respect to young patients in different series have been cardio vascular, pulmonary or urological. Regarding the com plications directly related to thyroidectomy, there were no differences compared to younger groups, except transient complications (hypoparathyroidism, seroma). In our experience, the main complication was repre sented by hypocalcemia (30.6%), permanent in 8% of cases. Cancer was relieved in 21.3% of cases.

* Correspondence: puzziello@unicz.it UU.OO di Chirurgia Generale e di Endocrinochirurgia, Università Magna Grecia di Catanzaro, Italy

Prognosis has been excellent in most cases, with immediate remission of symptoms related to thyrotoxi cosis and to tracheal and esophageal compression in almost all symptomatic patients.

Conclusions Age is an independent prognostic factor for cancers. It has been demonstrated that elderly patients with PTC that are operated have better prognosis and quality of life due to the resolution of dyspnea and dysphagia. In our experience, we think that age is not a contraindica tion to thyroid surgery.

Published: 24 August 2011

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doi:10.1186/1471231811S1A49 Cite this article as:Puzzielloet al.:Indications to total thyroidectomy for multinodular goiter in old patients.BMC Geriatrics201111(Suppl 1):A49.

© 2011 Puzziello et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.