Thyroidectomy is optimal treatment for Graves' disease

Area of Science:

• Endocrinology
• Surgical Oncology

Background:

• Graves' disease is an autoimmune disorder often treated with medication or radioactive iodine.
• Thyroidectomy is less common in the US due to concerns about recurrent laryngeal nerve and parathyroid gland injury.

Purpose of the Study:

• To evaluate the safety and efficacy of subtotal and total thyroidectomy for Graves' disease.
• To assess complication rates, including nerve injury and hypocalcemia, in a community hospital setting.

Main Methods:

• A retrospective and concurrent data collection of 65 consecutive patients undergoing thyroidectomy for Graves' disease between 1992 and 2010.
• One surgeon performed all procedures at a community-type hospital.

Main Results:

• No recurrent laryngeal nerve or external branch of the superior laryngeal nerve injuries occurred.
• Parathyroid glands were reimplanted in 9.2% of patients without subsequent hypocalcemia.
• 13.8% of patients experienced temporary hypocalcemia, with most weaned off calcium supplementation.

Conclusions:

• Total thyroidectomy provides a rapid and complete cure for Graves' disease.
• Extensive thyroidectomy for Graves' goiters can be safely performed in a community hospital setting with low complication rates.