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Updated: Aug 13, 2026
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Should the primary treatment of hyperthyroidism be surgical?
D A Linos1, D Karakitsos, J Papademetriou
1Department of Surgery, Athens Medical School, Greece.
Objective:
To review the results of the surgical treatment of all types of hyperthyroidism (Graves' disease, toxic nodular goitre, and toxic solitary adenoma).
Design:
Retrospective study.
Setting:
University hospital and private hospital, Greece.
Subjects:
400 Consecutive patients who were operated on between 1982 and 1991.
Intervention:
Near total/total thyroidectomy in 226 patients with toxic nodular goitre and 87 patients with Graves' disease. Subtotal thyroidectomy in 25 patients with Graves' disease (early period of the study); lobectomy with resection of the isthmus of the thyroid in 62 patients with a solitary toxic adenoma.
Main Outcome Measures:
Mortality, morbidity and patients' self assessment of the results of operation (symptoms, scar, ophthalmopathy).
Results:
There was no mortality. Morbidity included 2 postoperative bleeds that required reoperation; 2 patients developed permanent unilateral vocal cord paralysis and 2 had permanent hypoparathyroidism. In 27 of the 400 patients (7%) a thyroid carcinoma was found in the resected specimen. No patient had persistent or recurrent hyperthyroidism 2 to 10 years after operation. Of the 49 patients with Graves' disease and opthalmopathy at the time of operation, 35 (71%) reported improvement in their ophthalmopathy and 14 (29%) reported no improvement. No patient had worsening of their exophthalmos; 388 (97%) were satisfied with their incision; and 360 (90%) reported a significant improvement in their preoperative symptoms (tachycardia, weakness, anxiety, and pressure in the neck).
Conclusions:
We suggest that the primary treatment of all types of hyperthyroidism should be surgical.
