Thyroidectomy Remains a Safe Option for Graves' Disease.

Area of Science:

• Endocrinology
• Surgical Oncology
• Otolaryngology

Background:

• Graves' disease (GD) often necessitates surgical intervention, with total thyroidectomy (TT) or near-total thyroidectomy (NTT) frequently recommended over medical management.
• Assessing the safety and outcomes of TT/NTT across different surgical subspecialties is crucial for patient care.

Purpose of the Study:

• To evaluate the safety of TT/NTT for Graves' disease (GD) within various surgical subspecialties at a single institution.
• To identify patient-specific and surgical factors associated with intraoperative and postoperative outcomes.

Main Methods:

• A retrospective review was conducted on 383 patients who underwent TT/NTT for GD between 2004 and 2016.
• Data collected included patient demographics, thyroid gland size, surgeon subspecialty, and operative outcomes.
• Multivariate analyses were employed to identify risk factors for complications such as hypocalcemia and recurrent laryngeal nerve (RLN) paralysis.

Main Results:

• Otolaryngology, surgical oncology, and general surgery subspecialties performed TT/NTT. Surgical duration correlated with male gender and increased thyroid weight.
• No significant associations were found between patient factors or surgeon subspecialty and the occurrence of hypocalcemia or RLN paralysis.
• Estimated blood loss (EBL) was higher in younger patients, males, those with higher BMI, and larger thyroid glands, with variations noted across surgical subspecialties (general surgery > surgical oncology > otolaryngology).

Conclusions:

• TT/NTT is a safe and viable treatment option for patients with Graves' disease (GD).
• The study identified factors influencing surgical duration and blood loss but found no increased risk of major complications related to surgeon subspecialty.
• Further research may refine surgical approaches to minimize blood loss and optimize outcomes in GD patients undergoing thyroidectomy.