Clinical Features and Surgical Treatment of Thyroid Pathology in Patients Over 65 Years.

ABSTRACT

INTRODUCTION: The significant increase in the average lifespan of the general population lead to a proportional enhacement in the prevalence of benign and malignant thyroid conditions and equally the number of surgeries for this pathology. PATIENTS AND METHOD: In a personal series of 464 thyroid disorders undergoing surgery over a two decades period we registered 51 patients (10.9%) aged over 65 years of which 11 (2.4%) having over 75 years. Demographic, clinical and diagnostic characteristics of these cases were analysed together with indications, management practice and outcome. Retrospective statistical analysis reaearching risk factor and confidence interval has not identified factors predicting higher risk of complication in this age group. RESULTS: There have been recorded 33 females and 18 males (R1=1,8/1) with clinically, laboratory and histologically confirmed diagnosis of 24 (multi)nodular goiters (47.0%), 18 thyrotoxicosis (35.2%) and also 9 (17.6%) thyroid carcinomas. Thirty-four total or near total thyroidectomies and 17 conservative exeresis were performed. There were not postoperative deaths but we recorded three cases of prolonged hypocalcemia, and two cases each of recurrent laryngeal nerve paresis and recurrences. In all benign cases we obtained a stable in time cure while in carcinomas survivals of 3-5 years were obtained in only 4 papillary tumors. CONCLUSIONS: Despite some difficulties in diagnostic and additional risks related to comorbidity benign and malignant pathology installed in patients over 65 years, may benefit of all types of conservative or radical thyroidectomies in terms of strict monitoring individualized in each case.