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[Which thyroidectomy in Basedow disease?]

M R Pelizzo1, A Toniato, M E Girelli

  • 1Istituto di Chirurgia Generale I, Università degli Studi, Padova.

Minerva Chirurgica
|December 1, 1996
PubMed
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Thyroidectomy for Graves' disease can be subtotal or total. While total thyroidectomy has higher complication rates, neither difference was statistically significant. Subtotal thyroidectomy may avoid lifelong hormone replacement but can lead to persistent or relapsed hyperthyroidism.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Graves' disease is a common cause of hyperthyroidism.
  • Thyroidectomy is a primary surgical treatment for Graves' disease.
  • Comparing subtotal and total thyroidectomy outcomes is crucial for patient management.

Purpose of the Study:

  • To evaluate the outcomes of subtotal versus total thyroidectomy in patients with Graves' disease.
  • To analyze complication rates, remission rates, and the need for hormone replacement therapy.

Main Methods:

  • Retrospective analysis of 170 patients undergoing thyroidectomy for Graves' disease between 1987 and 1994.
  • Comparison of complication rates (bleeding, hypoparathyroidism, recurrent nerve lesion) between subtotal and total thyroidectomy.

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  • Assessment of long-term outcomes including hypothyroidism and hyperthyroidism remission.

    • Main Results:

    • Complication rates were higher in total thyroidectomies, but differences were not statistically significant.
    • Subtotal thyroidectomy did not consistently lead to remission, with some patients experiencing persistent or relapsed hyperthyroidism.
    • Total thyroidectomy resulted in a high rate of hypothyroidism requiring replacement therapy.

    Conclusions:

    • Both subtotal and total thyroidectomy are viable surgical options for Graves' disease.
    • The choice between subtotal and total thyroidectomy should be individualized based on intraoperative factors rather than theoretical advantages.
    • Careful patient selection and follow-up are essential for optimal surgical outcomes in Graves' disease.