New Research on Thyroid Surgery. Safer Practices for Elderly Patients
Medical doctors state that older people who undergo a thyroid surgery present lower rates of operation related complications and few readmissions. Thus, this type of surgery is safer in the case of older people. The investigation regarding this matter ranged over many years.
Melanie Seybt is a surgeon within the Medical College of Georgia in the division of neck and endocrine-head. She is the leading author of the study which was released in the Archives of Otolaryngology — Head and Neck Surgery edition. Accompanying her as co-authors are doctor Terris and student Sunny Khichi , both from the Medical College of Georgia . As the leading investigator explains the team believed that older people would be readmitted to the medical facilities more often than younger people, present a higher number of complications and a powerful cancer. However, the investigation group was shocked to discover the opposite situation.
The team`s investigation comprised a number of 428 patients undergoing thyroidectomy at the Medical College of Georgia Medical Center and the Charlie Norwood Veterans Affairs Medical Center. The research started in the year 2003 in November and ended in December of 2007. The patient sample comprised 44 people who were aged over 65 years and 86 patients who were aged between 21 years and 35 years. Studying these two groups, the researchers found that there were only slight variations between them.
The team of investigators discovered that they could undergo policlinic surgery for both of the groups at similar rates as follows: 45.5% in the older age group and 51.2% in the other one. The complication ratios were kind of similar since the elderly patients` group recorded 12.5% and presented ephemeral complications due to low calcium levels and the younger group summed up 11.1%. The thyroid cells` abnormal growth was thought to be of cancerous nature in 4.5% of the older age group and 2.3% in the other one. The results of the biopsies showed that in the elderly group 27.3% suffered from cancer and 18.6% of the young patients had developed malignant tumors. The older patients recorded a bigger medical facility admission ratio summing up 4.5% whereas the younger group recorded 1.2%. However, the above mentioned readmissions were linked to the ephemeral problems related to low levels of calcium and not issues associated with the advanced age. Last but not least, none of the two studied groups presented hemorrhages or permanent paralysis of the vocal cord after their thyroid surgery.
The leading surgeon hopes that her team`s discoveries would diminish the worries of sick people and physicians related to the safety degree of thyroidectomies in the increasing elderly population. Moreover, the investigators draw attention on the importance of screening prior to the surgery which is essential for any patient no matter his or her age. This screening proved to minimize the side-effects and complications in the case of advanced in age patients.
Even though the thyroid illness is very common in younger females, the figure recorded by old people who developed thyroid conditions is increasing. As the leading investigator of the study explains the sample of the research comprised 84 elderly patients. Looking at the statistics provided by the Census Bureau of the United States, the population of older persons has increased by approximately 90% during the past thirty years. Therefore, it is for sure that the geriatric population presents a growing trend.
As doctor Seybt states a high number of elderly patients present complications like heart failure, restrictive lung disease and hypertension. This is why the medical doctors take great care and put emphasis on knowing clear information regarding these patients in order to improve the treatment and practices used.
In addition, the leading surgeon says that operations on the head and neck provide a lower number of problems and a faster recovery rate compared to surgeries done on other body parts like the chest or abdomen. The well-known problems with the thyroid operation are linked to low levels of calcium in the patient`s body. This complication is triggered by the fact that by removing the thyroid gland its neighbors the parathyroid glands become a little bit frozen, but this is an ephemeral condition. In order to prevent such complications, people undergoing surgery are put under a calcium treatment for three weeks on a routine basis. However, there are times when this practice is not effective and adverse conditions such as numbness or, its opposite, tingling of the lips, hands or feet may occur. In addition, due to the fact that the vocal cords are near the thyroid gland, people may present temporary or permanent changes of their voice.
Even though the precise cause remains not known, thyroid illness has a trend of being genetic. Another cause for this condition is thought to be the exposure to radiation. However, in their battle to fight against thyroid cancer, doctor Seybt states that nowadays the medical world enjoys a variety of generally available and qualitative screening which can also take a non-invasive form like the ultrasound. This also means that in the long-run other causes for thyroid cancer would be discovered, no matter the age of the patient.
Nowadays, ultrasounds based on programs from the physicians` computers are more and more present in our community. This is why thyroid nodules could be found at an earlier development stage. Moreover, patients may undergo more thorough tests such as the MRI to scan their neck and head. However, the traditional finding of thyroid nodules is done by palpation either by the patient him or herself or by the physician. An important feature of these types of nodules is the fact that they may present no symptoms until they grow in size just enough to bother the swallowing and breathing processes. Even though some of the thyroid nodules may be observed by everyone when they grow in size, there are types which develop down towards one`s chest or to the back which are harder to be found. As the leading investigator of the research explains the nodules present in elderly patients might have developed in them for a time until they were discovered.
The medical doctors from the Medical College of Georgia and the Veterans Affairs Medical Center utilize one of the three existing approaches to counteract thyroid cancer, depending on the dimensions of the nodules. The approaches comprise the standard incision of a few inches done at the neck`s basis. This is done for the biggest in size nodule and then the surgeons undergo a slightly invasive thyroidectomy. The doctors operate thorough a cut which is 50% smaller than what they would need to see and use an endoscope in order to see on the video and also utilize a very small ultrasonic scalpel in order to diminish the cut by another 50%.
David Terris who is the chair of the Department of Otolaryngology-Head and Neck Surgery within the Medical College of Georgia School of Medicine is a specialist in minimal invasive surgeries. His work was presented in the Laryngoscope journal, the March edition. His approach clearly provided patients with smaller recovery time and cut dimensions. His practices are also safer for the majority of sick people.
