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Thyroid surgery in patients aged over 80 years
P Miccoli1, P Iacconi, G M Cecchini
1Cattedra di Endocrinochirurgia, Istituto di Clinica Chirurgica, University of Pisa, Italy.
Acta Chirurgica Belgica
|July 1, 1994
Summary
Thyroid surgery in octogenarians is safe and effective for benign and malignant conditions. Procedures for goiter causing airway compression or malignancy yielded excellent outcomes with no mortality.
Area of Science:
- Geriatric Surgery
- Endocrine Surgery
- Oncology
Background:
- Elderly patients (over 80 years) present unique challenges for thyroid surgery.
- Indications for surgery in this age group include compressive goiter and suspected malignancy.
Purpose of the Study:
- To evaluate the safety and efficacy of thyroid surgery in patients over 80 years old.
- To analyze surgical outcomes for both benign and malignant thyroid conditions in this elderly cohort.
Main Methods:
- Retrospective review of 12 patients aged over 80 undergoing thyroid surgery between 1987-1991.
- Surgical approaches included cervicotomy and median sternotomy.
- Frozen section analysis was used for suspected malignancies.
Main Results:
- Six patients had compressive goiter causing dyspnea; all were cured by surgery.
- Six patients had preoperative cytology suggesting malignancy; histology revealed 3 differentiated cancers, 2 anaplastic cancers, and 1 follicular adenoma.
- No intraoperative mortality or major complications occurred. Differentiated cancer patients survived 8-18 months post-surgery; anaplastic cancer patients had a mean survival of 12 months.
Conclusions:
- Thyroid surgery in octogenarians is associated with low morbidity and mortality.
- Surgical intervention provides significant relief for compressive goiter and offers survival benefits for differentiated thyroid cancer.
- Careful patient selection and surgical technique are crucial for successful outcomes in this age group.