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Total thyroidectomy for Graves' disease

M S Razack1, J M Lore, H A Lippes

  • 1Head and Neck Center, Sisters of Charity Hospital, Buffalo, New York 14214, USA.

Head & Neck
|August 1, 1997
PubMed
Summary
This summary is machine-generated.

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Total thyroidectomy is a safe and effective treatment for Graves' disease, with a low risk of complications. This surgical option offers a definitive solution for hyperthyroidism when performed by experienced surgeons.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Otolaryngology

Background:

  • Graves' disease hyperthyroidism treatment options include thiourea drugs, radioactive iodine ablation, and thyroidectomy.
  • Each treatment modality presents distinct advantages and potential complications.
  • The optimal therapeutic strategy for Graves' disease remains a subject of ongoing clinical debate.

Purpose of the Study:

  • To evaluate the safety and efficacy of total thyroidectomy for Graves' disease.
  • To assess postoperative outcomes, including recurrent hyperthyroidism, vocal cord function, and hypoparathyroidism.
  • To determine the morbidity associated with surgical management of Graves' disease.

Main Methods:

  • Retrospective analysis of 62 patients undergoing total thyroidectomy for Graves' disease over 11 years.

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  • Minimum 2-year postoperative follow-up with clinical and biochemical assessments.
  • Preoperative normalization of thyroid hormone levels and postoperative monitoring for complications.

    • Main Results:

    • No cases of recurrent hyperthyroidism observed; all patients maintained on levothyroxine.
    • Low incidence of vocal cord dysfunction (1.6% persistent immobility) and hypoparathyroidism (1.6% requiring long-term therapy).
    • Five percent of patients incidentally found to have papillary carcinoma.

    Conclusions:

    • Total thyroidectomy is a safe and effective treatment for Graves' disease.
    • Experienced head and neck surgeons can achieve low morbidity rates.
    • Surgical intervention should be presented as a viable option alongside radioactive iodine and pharmacologic therapy.