[Surgical treatment of hyperthyroidism (therapeutic and nosologic considerations from a personal experience of 2,395...

A retrospective analysis of the author's surgical experience (2,395 operations) demonstrates that the surgical treatment of hyperthyroid is nowadays simple and benign without mortality and with a very low morbidity. This dramatic improvement can be explained by the combination of a better medical preparation, and a meticulous surgical technic in the hands of an experimented team. The long term results are excellent with no recurrence of hyperthyroid. In about 30% of patients is observed a residual hypothyroid, which is milder, less evolutive and easier to manage than hypothyroid following radio-iodine therapy. Surgery thus appears in most cases to be the best solution, when the impossibility or failure of a medical treatment leads to consider a more radical approach. A classification of hyperthyroid lesions is proposed which seemed more suitable for the establishment of a rational surgical strategy. This classification is based on the opposition of diffuse hyperfunctional hyperplasia (with or without nodes) and localised toxic adenomas (single or multiple).