[Surgical treatment of hyperthyroidism]

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroid Surgery

Background:

• Hyperthyroidism management involves critical decisions regarding surgical indication, timing, and resection extent.
• Recurrence and complications are significant concerns in thyroid surgery for hyperthyroidism.

Purpose of the Study:

• To evaluate the surgical outcomes and recurrence rates in patients with different types of hyperthyroidism.
• To assess the effectiveness of specific surgical techniques based on the underlying thyroid pathology.

Main Methods:

• Retrospective analysis of 365 hyperthyroidism patients undergoing surgery.
• Surgical procedures included total extracapsular isthmectomy, subtotal thyroidectomy, and near-total thyroidectomy.
• Patient groups were categorized by diagnosis: monolateral autonomous nodules, diffuse multinodular goiter, and Graves disease.

Main Results:

• A low recurrence rate of 0.8% (3 out of 365 patients) was observed.
• Recurrences occurred in one patient with Graves disease (after subtotal thyroidectomy) and two with autonomous nodules (after isthmectomy).
• The study highlights that extensive resection, balanced with complication management, contributes to low recurrence rates.

Conclusions:

• Careful patient selection and appropriate surgical technique, including adequate resection extent, are crucial for successful hyperthyroidism surgery.
• Specific surgical approaches, such as extracapsular isthmectomy for autonomous nodules and subtotal/near-total thyroidectomy for multinodular goiter and Graves disease, yield favorable outcomes.
• The study supports the principle that maximizing resection extent, while minimizing complications, is key to preventing hyperthyroidism recurrence.