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Is euthyroidism the goal of surgical treatment of diffuse toxic goitre?
G Torre1, G Borgonovo, A Arezzo
1Istituto di Clinica Chirurgica, Università degli Studi di Genova, Italy.
Objective:
To find out by studying a homogeneous group of patients whether euthyroidism is achievable by surgical treatment of diffuse toxic goitre.
Design:
Retrospective study.
Setting:
Teaching hospital, Italy.
Subjects:
128 of the 152 patients operated on for diffuse toxic goitre during the period January 1971-December 1994 and followed up for a median of 83 months (range 6-289). INTERVENTION. Standard subtotal thyroidectomy.
Main Outcome Measures:
Operative mortality, recurrence, hypothyroidism and late complications.
Results:
There were no operative deaths. After 10 years follow up, 11 patients (9%) had developed recurrences and 61 (48%) were euthyroid. In the univariate analysis the risk of hypothyroidism was significantly associated with the year of operation (p = 0.04), the duration of symptoms (p < 0.01), and the degree of lymphocytic infiltration (p < 0.01). The last two were confirmed by multivariate analysis.
Conclusion:
Subtotal thyroidectomy seems to be an effective treatment of diffuse toxic goitre as a stable euthyroid state can be achieved in nearly half the patients after a prolonged follow up.