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[Basedow disease. From subtotal to total thyroidectomy].

E Gemsenjäger1, Ph Valko, I Schweizer

  • 1Chirurgische Klinik, Spital Zollikerberg, Zollikerberg.

Praxis
|March 6, 2002
PubMed
Summary
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Extensive or total thyroidectomy for Graves' disease significantly reduces recurrence rates. Near-total thyroidectomy offers low morbidity and is the preferred surgical approach for long-term recurrence-free survival.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Context:

  • Graves' disease management relies on understanding its pathophysiology and employing optimal surgical techniques.
  • Surgical treatment for Graves' disease has evolved with advancements in pathophysiological knowledge and surgical approaches.

Purpose:

  • To evaluate the efficacy of subtotal versus total thyroidectomy in managing Graves' disease.
  • To assess surgical outcomes, including recurrence rates, morbidity, and functional results, following thyroidectomy for Graves' disease.

Summary:

  • This audit of 81 patients undergoing thyroidectomy for Graves' disease demonstrated a shift towards total thyroidectomy, with remnant size decreasing significantly.
  • Total thyroidectomy was associated with a 100% recurrence-free survival at 10 years for remnants < 3g, compared to 55.8% for remnants 3-6g.

Related Experiment Videos

  • Surgical morbidity was low, with no permanent hypoparathyroidism. Ophthalmopathy improved in 70% of patients, independent of the extent of thyroidectomy.

    • Impact:

    • Near-total thyroidectomy is recommended for Graves' disease to ensure long-term recurrence-free survival.
    • The study highlights the importance of meticulous surgical technique, such as capsular dissection, in achieving optimal outcomes.
    • Findings support total thyroidectomy as the treatment of choice due to its low morbidity and potential for complete autoantigen removal.