Changes in the thyroid function of Graves' disease patients treated by subtotal thyroidectomy

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroidology

Background:

• The optimal extent of thyroidectomy for Graves' disease remains controversial.
• Subtotal thyroidectomy is a standard procedure in Japan, but associated with high hyperthyroidism relapse rates.

Purpose of the Study:

• To evaluate serial changes in thyroid function post-subtotal thyroidectomy for Graves' disease.
• To determine if subtotal thyroidectomy is suitable as a standard surgical procedure.

Main Methods:

• Retrospective study of 478 Graves' disease patients undergoing subtotal thyroidectomy (1994-1997).
• Thyroid function assessed 2-3 years (early) and 8-10 years (late) post-surgery.
• Analysis of thyroid function stability and relapse rates.

Main Results:

• In the late period, 30% of initially euthyroid patients relapsed with hyperthyroidism, and 13% became hypothyroid.
• Approximately 80% of patients with overt hyperthyroidism or hypothyroidism in the early period remained in that state long-term.
• Among patients with subclinical hyperthyroidism, 42.6% developed overt hyperthyroidism, and 23.4% achieved remission.

Conclusions:

• Thyroid function after subtotal thyroidectomy for Graves' disease is unstable.
• The procedure negatively impacts quality of life, making it unsuitable as a standard surgical treatment.