Miccoli P, Iacconi P, Cecchini G M, Caldarelli F, Ricci E, Berti P, Puccini M
Cattedra di Endocrinochirurgia, Istituto di Clinica Chirurgica, University of Pisa, Italy.
Acta Chir Belg. 1994 Jul-Aug;94(4):222-3.
In the past 5 years (1987-1991), we admitted for thyroid surgery 12 patients older than 80 years. Indications for surgery were represented by goiter causing tracheal compression and severe dyspnoea in 6 cases, and by preoperative cytological report of malignancy in the other 6 cases. The dyspnoea represented an absolute surgical indication. All patients but one were treated by cervicotomy; in one case we performed a median sternotomy. Frozen section was performed in all patients with cytological report of malignancy. Histology detected 3 differentiated cancers, 2 anaplastic cancers, and one follicular adenoma. The patients with benign disease were treated by 4 subtotal thyroidectomies and 3 total lobectomies. Three out of 5 affected by malignant lesions were submitted to a total thyroidectomy (differentiated carcinomas) and 2 to palliative thyroidectomy (anaplastic carcinoma). In this series there were neither intraoperative mortality nor major surgical complications. All the patients with dyspnoea were cured by surgery. All the patients affected by differentiated cancer were alive and well 8, 13 and 18 months after surgery. The mean survival of patients with anaplastic cancer was 12 months.
在过去5年（1987 - 1991年），我们收治了12例年龄超过80岁的患者进行甲状腺手术。手术指征包括：6例因甲状腺肿导致气管受压并伴有严重呼吸困难，另外6例术前细胞学报告为恶性肿瘤。呼吸困难是绝对的手术指征。除1例患者外，所有患者均接受了颈部切开术；1例患者进行了胸骨正中切开术。所有术前细胞学报告为恶性肿瘤的患者均进行了冰冻切片检查。组织学检查发现3例分化型癌、2例未分化癌和1例滤泡性腺瘤。良性疾病患者接受了4例甲状腺次全切除术和3例甲状腺叶全切除术。5例恶性病变患者中，3例接受了甲状腺全切除术（分化型癌），2例接受了姑息性甲状腺切除术（未分化癌）。在这个系列中，既没有术中死亡病例，也没有严重的手术并发症。所有呼吸困难患者均通过手术治愈。所有分化型癌患者在术后8、13和18个月时均存活且状况良好。未分化癌患者的平均生存期为12个月。
