The relationship between thyroidectomy complications and body mass index

SUMMARY INTRODUCTION: Obesity is a growing public health problem associated with many comorbid diseases. The aim of this study was to evaluate the relationship between body mass index and complications of thyroidectomy. METHODS: Patients who underwent total thyroidectomy between January 2015 and December 2018 were enrolled. Patients were divided into two groups, i.e., BMI <25 (group A) and BMI≥ 25 (group B). Demographics, operative time, and complications were retrospectively reviewed. RESULTS: The study included 145 patients (66 in Group A and 79 in Group B). There was no significant difference between the two groups in terms of age (p=0.330) and gender (p=0.055). No surgical site infection and bleeding complications were observed in any patients. The mean operative time was 148.4 minutes (90-235) in Group A and 153.4 minutes (85-285) in Group B (p=0.399). Transient hypocalcemia was observed in 25 (37.9%) patients in group A, and 23 (29.1%) patients in Group B (p = 0.291). Permanent hypocalcemia was not observed in any patient in group A, and in 2 patients in Group B (2.5%) (p = 0.501). Transient recurrent nerve palsy was observed in 1 (1.5%) patient in Group A and in 3 (3.8%) patients in Group B (p=0.626). None of the patients had permanent recurrent nerve palsy. Parathyroid autotransplantation was performed on 1 patient (1.5%) in group A and on 7 (8.9%) patients in Group B (p=0.055). CONCLUSION: We think there is no relationship between a high BMI and thyroidectomy complications, and surgery can also be performed safely in this patient group.

RESUMO INTRODUÇÃO: A obesidade é um crescente problema de saúde pública associado a muitas doenças comórbidas. O objetivo deste estudo foi avaliar a relação entre o índice de massa corporal e as complicações da tireoidectomia. MÉTODOS: Os pacientes submetidos a tireoidectomia total entre janeiro de 2015 e dezembro de 2018 foram incluidos. Os pacientes foram divididos em dois como IMC <25 (grupo A) e IMC . 25 (grupo B). Demografia, tempo operatorio e complicacoes revisadas retrospectivamente. RESULTADOS: O estudo incluiu 145 pacientes (66 no grupo A e 79 no grupo B). Não houve diferença significativa entre os dois grupos em termos de idade (p = 0,033) e sexo (p = 0,055). Nenhuma infecção do sítio cirúrgico e complicações hemorrágicas foram observadas em nenhum paciente. O tempo operatório médio foi de 148,4 minutos (90-235) no grupo A e 153,4 minutos (85-285) no grupo B (p = 0,399). Hipocalcemia transitória foi observada em 25 (37,9%) pacientes do grupo A e 23 (29,1%) do grupo B (p = 0,291). Hipocalcemia permanente não foi observada em nenhum paciente do grupo A e em 2 pacientes do grupo B (2,5%) (p = 0,501). Paralisia nervosa recorrente transitória foi observada em 1 (1,5%) paciente no grupo A e em 3 (3,8%) pacientes no grupo B (p = 0,626). Nenhum dos pacientes apresentou paralisia nervosa recorrente permanente. O autotransplante de paratireóide foi realizado em 1 paciente (1,5%) no grupo A e em 7 (8,9%) pacientes no grupo B (p = 0,055). CONCLUSÃO:: Acreditamos que não há relação entre um IMC alto e as complicações da tireoidectomia e a cirurgia pode ser realizada com segurança também neste grupo de pacientes.

Outcomes of Laparoscopic Cholecystectomy in Patients 65 Years and Older.

Aim: Laparoscopic surgery is considered to be the gold standard in gall bladder surgery and to take advantage of its benefits, the number of laparoscopic procedures carried out on elderly patients is increasing daily. The aim of this study was to determine the mortality and morbidity rates of laparoscopic cholecystectomy (LC) in a patient group over 65 years of age and to analyze the predictive factors for conversion to open surgery. Study Design: A retrospective analysis of patients, 65 years of age and over, who had undergone laparoscopic cholecystectomy operation. Place and Duration of Study: Tepecik Training and Research Hospital, Department of General Surgery, Izmir, Turkey between January 2012 and June 2014 in our clinic was conducted. Methodology: A retrospective analysis of 385 patients, 65 years of age and over, who had undergone cholecystectomy operation When excluding the patients who had open cholecystectomy or additional surgical procedures, 240 patients were included in the study. The patients were also divided into two age groups (65-74 years; 75+ years) for further analysis. Results: The median age of the patients was 70. The rate of conversion from laparoscopy to open surgery was 12.5% (n=30). Multivariate analysis showed the leukocytosis and pathological acute cholecystitis to be independent risk factors for conversion. A longer total hospital stay was seen in patients with inflammatory bile duct diseases (5±4 days - 3±2 days). The surgical morbidity rate was 19.6% (n= 47); the rate of systemic complication was 2.5% (n=6). Conclusion: Inflammation related to gallstones in the biliary system is a definite risk factor for conversion to open surgery. Laparoscopic cholecystectomy, with its acceptable rates of morbidity, mortality and conversion, is a reliable surgical procedure in the 65 and over age group.