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The Thyroid Gland01:23

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
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The long-term outcomes of thyroid function after subtotal thyroidectomy for Graves' hyperthyroidism.

Yann-Sheng Lin1, Jen-Der Lin2, Chih-Chieh Hsu1

  • 1Department of Surgery, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University, Taoyuan City, Taiwan (R.O.C.).

The Journal of Surgical Research
|November 29, 2017
PubMed
Summary

Subtotal thyroidectomy for Graves' disease (GD) leads to high recurrence rates and low euthyroid states. Preserving thyroid function with this method is not optimal for definitive GD treatment.

Keywords:
Graves' diseaseHyperthyroidismRecurrenceSubtotal thyroidectomy

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Graves' disease (GD) management is shifting towards total thyroidectomy to prevent recurrence.
  • Subtotal thyroidectomy is still used in some regions to preserve thyroid function.
  • Long-term outcomes of subtotal thyroidectomy for GD require further investigation.

Purpose of the Study:

  • To evaluate the long-term outcomes of subtotal thyroidectomy in Graves' disease patients.
  • To determine the correlation between thyroid remnant weight and postoperative thyroid function.
  • To assess the efficacy of subtotal thyroidectomy in achieving a sustained euthyroid state.

Main Methods:

  • Retrospective cohort observation study.
  • Inclusion of 415 consecutive GD patients undergoing subtotal thyroidectomy (2005-2011).
  • Median follow-up of 72 months.

Main Results:

  • 28.7% of patients experienced persistent or recurrent hyperthyroidism.
  • Over 50% of patients developed hypothyroidism.
  • Only 19.3% achieved a stable euthyroid state; remnant weight was a risk factor for recurrence.

Conclusions:

  • Subtotal thyroidectomy is not an optimal strategy for definitive Graves' disease treatment.
  • High rates of recurrence and low rates of sustained euthyroid state were observed.
  • The strategy fails to reliably maintain thyroid function post-surgery.