title: Thyroid surgery in geriatric patients: a literature review.
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.
authors.affiliation: Endocrinosurgery Unit, Dept of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy. puzziello@unicz.it.
authors.forename: Rita
authors.initials: R
authors.lastname: Gervasi
authors.forename: Giulio
authors.initials: G
authors.lastname: Orlando
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Lerose
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.forename: Pio
authors.initials: P
authors.lastname: Zeppa
authors.forename: Alessandro
authors.initials: A
authors.lastname: Puzziello
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006042:Goiter / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D013959:Thyroid Diseases / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome