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This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery

Open Access Research article

Thyroid surgery in geriatric patients: a literature review

Rita Gervasi3, Giulio Orlando3, Maria Antonietta Lerose3, Bruno Amato1, Giovanni Docimo2, Pio Zeppa2 and Alessandro Puzziello3*

Author Affiliations

1 General Surgery Unit, Dept of General Surgery, Geriatric and Endoscopy, University Federico II, Naples, Italy

2 VII General Surgery Unit, Dept of General Surgery, Second University of Naples, Italy

3 Endocrinosurgery Unit, Dept of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy

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BMC Surgery 2012, 12(Suppl 1):S16  doi:10.1186/1471-2482-12-S1-S16

Published: 15 November 2012

Abstract

Background

Thyroid disease is common in the elderly population. The incidence of hypothyroidism and multinodular goitre gradually increases with age. In view of a growth of aging population, we performed a literature review about the feasibility of thyroid surgery in the elderly.

Methods

We conducted a literature search in the PubMed database in September 2012 and all English-language publications on thyroidectomy in geriatric patients since 2002 were retrieved. The potential original articles mainly focusing on thyroidectomy in elderly patients were all identified and full texts were obtained and reviewed for further hand data retrieving.

Results

We retrieved five papers based on different primary end-point. Four were retrospective non randomized studies and one was prospective non randomized study. At last 65, 70, 75 and 80 years were used as an age cut-off. All studies evaluate the indications of thyroidectomy in geriatric patients, postoperative morbility and mortality. Only one study specifically assesses the rate of the rehospitalization after thyroidectomy among the elderly.

Conclusions

Thyroid nodules are particularly important in elderly patients, as the incidence of malignancy increases and they are usually more aggressive tumors. An age of at least 70 years is an independent risk factor for complications after general surgery procedures. 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. A programmed operation with a careful pre-operative evaluation and a risk stratification should make the surgical procedures less hazardous, specially in 80 years old patients with an high ASA score.