Surgical treatment for multinodular goitres in geriatric patients

Rı́os, Antonio; Rodrı́guez, José Manuel; Galindo, P.J.; Canteras, Manuel; Parrilla, Pascual

doi:10.1007/s00423-004-0521-8

Cited by 39 publications

(29 citation statements)

References 28 publications

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“…The ratio of signal enhancement to noise (SE/N) was calculated as defined by Inoue et al, 13 as follows: SE/N=(S post −S pre )/NSD), where S post is signal intensity after injection, S pre is signal intensity before injection, and NSD is standard deviation of the background. Timeintensity curve patterns reflected the following 3 patterns of contrast enhancement: (1) delayed washout pattern in which the timeintensity curve was less than half of peak grade during 10 minutes (Figure 1 and Figure 2), (2) rapid washout pattern in which the time-intensity curve was less than half of peak grade within 10 minutes (Figure 3), and (3) no contrast enhancement.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Value of Dynamic Contrast Medium–Enhanced Magnetic Resonance Imaging in Preoperative Detection of Thyroid Carcinoma

Tezelman

Giles²,

Tunca³

et al. 2007

Arch Surg

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Section: Methodsmentioning

confidence: 99%

“…1,2 The presence of a dominant cold nodule in a thyroid gland with multiple nodules is an important risk factor associated with thyroid carcinoma. 3 Differentiation of a benign thyroid nodule from a malignant thyroid nodule is important in planning the further therapeutic approach and the extent of surgical intervention.…”

Section: T He Primary Indications Formentioning

confidence: 99%

Diagnostic Value of Dynamic Contrast Medium–Enhanced Magnetic Resonance Imaging in Preoperative Detection of Thyroid Carcinoma

Tezelman

Giles²,

Tunca³

et al. 2007

Arch Surg

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“…In our study we observed a significant higher rate of tracheal compressive symptoms in the elderly. Even higher rates were reported by Rios et al [17], who noted a correlation of compressive symptoms with longer time of goiter evolution and higher percentage of an intrathoracic component. Consequently, their older patients treated for multinodular goiter had a longer duration of surgery, more intraoperative blood loss, and larger resected thyroid glands.…”

Section: Discussionmentioning

confidence: 76%

“…Although there was no between-group difference in rates of surgery-related complications in Lang and Lo's [13 ]study, the older group had significantly more nonsurgical complications, mainly respiratory, probably due to the larger goiter size and the preoperative airway obstruction. Nevertheless, Rios et al [17] reported that the preoperative symptoms remitted in all patients after surgery.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Surgery in the Elderly

Schwartz¹,

Shpitzer²,

Feinmesser³

et al. 2013

Gerontology

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Background: The increase in life expectancy combined with the relatively high incidence of thyroid disease requiring surgery in the elderly has raised questions concerning the appropriate management of the older patient. Aim: Evaluation of the surgical management and outcome of thyroid disease requiring surgery in elderly patients. Methods: We performed a retrospective cohort study, in which the medical charts of 2,239 patients who underwent total thyroidectomy or hemithyroidectomy between 1995 and 2011 in a tertiary medical center were reviewed for clinical, disease-related, operative and outcome measures. Findings were analyzed between the patients aged more than 75 years for whom complete information was available (n = 255) and a control group of 100 patients aged 40-60 years matched for sex and extent of surgery. Results: The prevalence of comorbidities was significantly higher in the elderly. Presenting symptoms were similar in the two groups; in approximately 25% of both groups thyroid cancer was an incidental finding. There were no between-group differences in surgery duration, time to anesthesia induction, recovery time from anesthesia, or rate of postoperative complications. Hospitalization was 3 days longer on average in the older group. Malignancy rates and distribution of histologic subtypes were similar in the two groups, although the older group presented with significantly higher rates of advanced disease stage and larger tumors. There were no differences in recurrence rate both locoregional and distant metastases. However, a higher proportion of older patients failed to achieve cure. Conclusion: Although older patients with thyroid disease have more comorbidities and advanced disease, there is no practical difference in their operative management and surgical outcome compared to younger patients. Surgery should not be deferred solely on the basis of age in the presence of compelling indications; rather, the decision should be based on individual risk-benefit analysis.

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“…While most studies (Christian Passler et al, 1 Melanie W. Seybt et al, 3 Michael C. Sullivan et al, 4 Ríos A et al 5 and Rodríguez et al 6 ) found that there is no greater risk for thyroid surgery in the elderly. One study (Mekel et al) 7 found a higher increase in morbidity in older group.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Surgery in Geriatric Patient: Experience in a Tertiary Care Centre in Rural Kerala

Jose¹,

Paul²,

Mohammad³

et al. 2014

jemds

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OBJECTIVE:To study about additional risks associated with thyroid surgery in the elderly population. DESIGN: Retrospective analysis of a prospective documented data in consecutive patients undergoing thyroid surgery from January 2012 to June 2014 in a tertiary care health center. PATIENTS: The study included patients aged 30 to 40 years as control group and patients of 60 years and above who underwent thyroidectomy. MAIN OUTCOME MEASURES: Pathology reports, complications (including rates of temporary and permanent hypocalcemia and stridor, seroma/hematoma, and duration of hospital stay. RESULTS: There were 68 patients of 30-40 age group who under-went thyroidectomy between January 2012 and June of 2014; 46 elderly patients underwent surgery during that same time frame. There were no deaths in both cohort, and no cases of permanent TVF paralysis. The elderly patients had a similar rate of complications when compared with the younger patients, (60% vs 70%) but a higher duration of hospital stay (6.9 vs 5.4). CONCLUSIONS: Thyroid surgeons will be faced more often with the prospect of elective thyroid surgery in patients of advanced age, as an increasingly aged population emerges and the prevalence of thyroid nodules and thyroid cancer increases. Thyroid surgery in optimized elderly patients is safe and no more dangerous, than surgery in younger patients though the duration of hospital stay is more.

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Surgical treatment for multinodular goitres in geriatric patients

Cited by 39 publications

References 28 publications

Diagnostic Value of Dynamic Contrast Medium–Enhanced Magnetic Resonance Imaging in Preoperative Detection of Thyroid Carcinoma

Diagnostic Value of Dynamic Contrast Medium–Enhanced Magnetic Resonance Imaging in Preoperative Detection of Thyroid Carcinoma

Thyroid Surgery in the Elderly

Thyroid Surgery in Geriatric Patient: Experience in a Tertiary Care Centre in Rural Kerala

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