Comparison of postoperative complications acording to age groups in patients who undergone total thyroidectomy

Introduction: Thyroidectomy is one of the mostly applied operation in generalsurgery clinics. Despite the mortality and morbidity of rates are too low, some certaincomplications may have effects on patients' remaining life. İn elderly treatment of thedisease needs more attention because of greater riscs of complications. Especially inendemic regions, increasing recurrence and malignity rates in greater ages, totalthyroidectomy is mostly preferred operation alternative. But safety and applicability of thisalternative in elderly still remains controversial. İn this study young and elderly patientgroups are compared in terms of postoperative complications.Material and Method: İn this study, 150 patients who underwent surgery withDelbridge capsular dissection technique are followed prospectively. The patients areevaluated in terms of age, sex, preoperative diagnosis, operation time, bleeding quantityduring operation, blood calcium, dysphonia, infection of region of operation, hematoma,existent of seroma, scar formation, time of stay in hospital and malignity rates. Thedifference of these factors in young and elderly patients are compared.Findings: In 44 of 150 patients transient hypocalcemia developed. 19 of thesepatients were under 50 years old and 25 were above 50 years old. İn 8 patients permanenthypocalcemia is developed, 3 of the patients were under 50 years old and 5 of the patientswere above 50 years old. İn one of the patients bilateral recurrent laryngeal nerve injurywas observed and age of the patient was above 50 years. Unilaterally recurrent nerve injurywere observed in one patient under 50 years old and one patient above 50 years old.Temporary recurrent nerve injury was observed in 3 patients in under 50 years old groupand 4 patients in the elderly group. Postoperatively main staying time at hospital was 3.61days; the minimum time was 2 days and the maximum time was 10 days. After theoperation in group under 50 years old, in 1 patient hematoma, and in 1 patient operationregion infection was developed. İn group above 50 years old, in 1 patient hematoma, in 1patient seroma, and in 1 patient operation region infection was developed. V.A.S. (VisualAnalog Scale) scoring was made in evaluation of the operation scar of the patients and themean V.A.S. score was 10.11. The minimum V.A.S. score was 8 and the maximum scorewas 15. İn the group under 50 years old the mean value was 9,36 and in above 50 years oldgroup the score was 10.88. While swallowing in 8 patients mobile scars and in 3 patientsfiksed scars were observed. After evaluation of specimens histopathologically, 128 caseswere benign (60 in >50 years, 68 in<50 years), 22 cases were malign (14 in >50 years, 8 in<50 years).Conclusion: Especially in endemic regions, total thyroidectomy is mostly preferredoperation alternative because of the increased rates of recurrence and malignity riscs.Because of developing surgical techniques and the progression in anaesthesia applicationstotal thyroidectomy would be safely apllied in elderly patients. İn total thyroidectomyoperations there are no more significant difference between the young and elderly patientsexcept healing of the operation scar.