Short-stay thyroid surgery for older patients, is it safe?

Abstract

Background/Aim. The incidence of nodular thyroid disease increases significantly with age as well as the incidence and aggressiveness of thyroid cancers. The aim of this study was to determine if thyroid surgery for geriatric patients is safe in a short hospital stay surgery setting. Methods. In this retrospective study we have analyzed medical histories of all operated geriatric patients (65 years and older) in which a total or hemithyroidectomy was performed in the period from January 2012 to December 2018. Patients with thyroid reoperations and with simultaneous neck dissections were excluded from the study. The analyzed geriatric patients were divided into hemithyroidectomy and total thyroidectomy groups and were paired with two control age groups (20-44 years and 45-64 years), in a numerical ratio of 1: 1: 1. Results. 976 patients were operated of the thyroid diseases, 214 total thyroidectomies and 33 hemithyroidectomies. In all three hemithyroidectomy groups the average hospital stay was 24 hours, in the total thyroidectomy geriatric group 150 of 214 patients (70.1%) spent 24 hours in the hospital. In the geriatric population, incidence of neck swelling and increased drainage output were higher compared to the control group, and thus the need for longer hospitalizations. Comparing the years, it was shown that subjects with each subsequent year of intervention have a 22% lower chance of developing complications, and regarding pathohistological finding benign thyroid hyperplasia is less likely to develop complications compared to malignant hyperplasia. Conclusion. According to our study total thyroidectomy can be safely performed within the concept of a short hospital stay in patients under 65, while in the elderly, hospitalization days may be extended due to more frequent surgical and non surgical complications, while hemithyroidectomy is safe for all age groups.