[Surgical treatment of Basedow's disease. Study of a homogenous series of 105 cases]

Basedow's disease was the indication for surgery in 105 of 3000 operations on the thyroid performed over the last 15 years. The choise of operative therapy was based on age of patient, size of thyroid, and the failure of medical treatment to provide more than partial improvement or to prevent recurrence. Pre-operative preparation must follow a strict procedure. Surgery was initially by bilateral subtotal lobectomy, soon modified to include a left total combined lobectomy with a right subtotal lobectomy (25 p. 100 of operations). Postoperative complications among the first patients treated, in 1966, included one death from an acute toxic reaction, three lesions of the recurrent nerves (only one was permanent) and four cases of hypothyroidism (three were transient). A one to 15 years follow up was possible in 80 p. 100 of the patients. Recurrence was noted in 9 cases, two of these developing after a long period (6 and 10 years respectively). These recurrences appear to be related the sex (males), age (under 40 years), weight of goitre (50 g and over), and the type of excision (bilateral subtotal as against unilateral total lobectomy). Of the 74 patients failing to develop a relapse, 80 p. 100 were normothyroidal and 20 p. 100 hypothyroidal, while 91 p. 100 were sujectively with the results of their operation.