Inversini Davide, Morlacchi Andrea, Melita Giuseppinella, Del Ferraro Simona, Boeri Carlo, Portinari Mattia, Cancellieri Antonino, Frattini Francesco, Rizzo Antonio Giacomo, Dionigi Gianlorenzo
ASST Sette Laghi Ospedale di Circolo e Fondazione Macchi, Varese 21100, Italy.
Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood G. Barresi, University Hospital Policlinico G. Martino, University of Messina, Messina 98125, Italy.
Gland Surg. 2017 Oct;6(5):587-590. doi: 10.21037/gs.2017.10.01.
Worldwide, the indications for thyroid surgery have been continuously extended among elderly patients in the last 20 years. The balance between treatment indication and surgical risk is certainly an interesting topic for every thyroid surgeon. This paper is a review of recent literature from January 2005 up to April 2017. We analyzed three principal subjects: indications for surgical treatment, medical complications and surgical complications. We can summarize the conclusions of our analysis, stating that age could not be considered as an absolute factor, but in relation to the comorbidities and the general clinical condition of the patient. Special risk indices dedicated to geriatric patients could be very useful in order to facilitate the decision-making process; however, relying on the current knowledge, we could state that there is value in providing surgery to geriatric patients in highly specialized and high-volume centers, where access to technology and its systematic use, coupled with surgeons' experience, could certainly avail the geriatric patient management.
在全球范围内,过去20年里老年患者甲状腺手术的适应症不断扩大。治疗适应症与手术风险之间的平衡无疑是每位甲状腺外科医生感兴趣的话题。本文是对2005年1月至2017年4月近期文献的综述。我们分析了三个主要主题:手术治疗适应症、医疗并发症和手术并发症。我们可以总结分析结论,即年龄不能被视为绝对因素,而应结合患者的合并症和总体临床状况来考虑。专门针对老年患者的特殊风险指数对于促进决策过程可能非常有用;然而,基于目前的知识,我们可以说,在高度专业化且手术量较大的中心为老年患者提供手术是有价值的,在这些中心,技术的获取及其系统应用,再加上外科医生的经验,肯定有助于老年患者的管理。