老年患者甲状腺疾病的外科治疗。
Surgical treatment of thyroid diseases in elderly patients.
机构信息
Division of Endocrine Surgery-Department of Surgery, Università Cattolica del Sacro Cuore, L. go A. Gemelli 8, 00168 Rome, Italy.
出版信息
Am J Surg. 2010 Oct;200(4):467-72. doi: 10.1016/j.amjsurg.2009.12.020.
BACKGROUND
We evaluated the safety of thyroid surgery in elderly patients, in whom surgical procedures usually are considered more hazardous than in younger patients.
METHODS
The medical records of all the patients who were aged 70 years or older who had undergone thyroid surgery between January 1998 and June 2008 were reviewed.
RESULTS
A total of 320 patients were included. The preoperative diagnosis was multinodular goiter in 171 cases, toxic goiter in 59 cases, suspicious or indeterminate thyroid nodule in 60 cases, and thyroid carcinoma in 30 patients. Total thyroidectomy was performed in 283 patients, thyroid lobectomy in 15 patients, and a completion thyroidectomy was performed in 22 patients. The final histology showed thyroid cancer in 86 patients and benign disease in 234.
CONCLUSIONS
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.
背景
我们评估了老年患者甲状腺手术的安全性，与年轻患者相比，老年患者的手术通常被认为更具危险性。
方法
回顾了 1998 年 1 月至 2008 年 6 月间所有年龄在 70 岁或以上接受甲状腺手术的患者的病历。
结果
共纳入 320 例患者。术前诊断为 171 例多结节性甲状腺肿，59 例毒性甲状腺肿，60 例可疑或不确定甲状腺结节，30 例甲状腺癌。283 例患者行甲状腺全切除术，15 例患者行甲状腺叶切除术，22 例患者行甲状腺次全切除术。最终组织学检查显示 86 例甲状腺癌和 234 例良性疾病。
结论
70 岁或以上患者的甲状腺手术是安全的，相对较高的甲状腺癌和毒性甲状腺肿发生率可能证明积极的手术方式是合理的。
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