Outcomes of sutureless total thyroidectomy in elderly

Area of Science:

• Endocrinology
• Surgical Oncology
• Geriatric Medicine

Background:

• Thyroid disease, including hypothyroidism and multinodular goiter, is prevalent in the elderly.
• Surgical interventions in older adults are often perceived as higher risk.
• Minimally invasive hemostatic techniques are evolving for thyroidectomy.

Purpose of the Study:

• To compare the outcomes of total thyroidectomy in elderly versus younger patients.
• To evaluate the efficacy of different energy devices in thyroid surgery.
• To assess the safety and effectiveness of Harmonic Focus and Ligasure Precise/Small Jaw in elderly patients undergoing total thyroidectomy.

Main Methods:

• A study involving 255 patients, with 105 in the elderly group (>70 years) and 150 in the young group (18-69 years).
• Patients were divided into subgroups based on surgical technique: conventional, Ligasure Precise/Small Jaw, or Harmonic Focus.
• Intra-operative and post-operative data, including complication rates, were collected and analyzed.

Main Results:

• Total thyroidectomy demonstrated similar safety profiles in both elderly and younger patient groups.
• The use of Harmonic Focus or Ligasure Precise/Small Jaw significantly reduced surgical duration compared to the conventional approach.
• Hemorrhage, hypocalcemia, and vocal cord paralysis rates were comparable across all surgical technique subgroups.

Conclusions:

• Total thyroidectomy is a safe and effective procedure for elderly patients, comparable to younger populations.
• Harmonic Focus and Ligasure Precise/Small Jaw offer a safe, effective, and time-efficient alternative to traditional ligation techniques.
• Energy devices enhance thyroidectomy by reducing operative time and maintaining low complication rates in all age groups.