| Abstract | AIM OF THE STUDY: To evaluate morbidity and functional results of surgical treatment in patients with Graves' disease. METHODS: A retrospective study was performed in 108 patients operated on during 1993-2003. Main indications for surgery were failure of treatment with antithyroid drugs (80.6%), large goiter (46.3%) and/or severe ophthalmopathy (23.1%). Surgical procedures were extensive subtotal thyroidectomy (EST; n = 33; uni- or bilateral remnant of <2 g) or total thyroidectomy (TT; n=75). Functional results were established in 89 patients (27 EST patients and 62 TT patients) after a mean follow-up of 5.9 years. RESULTS: Operative mortality was zero. There were 4 (3.7%) transient unilateral recurrent laryngeal nerve (RLN) palsies and no cases of permanent RLN palsy. Temporary hypocalcemia occurred in 15 patients (13.9%) and permanent hypoparathyroidism resulted in two (1.9%). Four patients (3.7%) developed a postoperative hematoma that required reoperation. There was no significant difference in the rate of complications between EST and TT, although temporary hypocalcemia was more common following TT than EST (17.3% vs. 6.1%) and permanent hypoparathyroidism affected only TT patients. None of the patients developed recurrent hyperthyroidism; all patients are maintained on levothyroxine. CONCLUSIONS: Surgery is an effective therapy for selected cases of Graves' disease. When performed by experienced surgeons, it can be carried out with no mortality and minimal morbidity. EST (with uni- or bilateral remnant of <2 g) and TT are both effective in order to achieve a definitive cure of hyperthyroidism. |
| Authors | N Palestini, M Grivon, G Carbonaro, R Durando, M Freddi, C Odasso, G Sisto, A Robecchi
(Affiliation: Dipartimento di Discipline Medico-Chirurgiche, Sezione di Chirurgia Generale, Università degli Studi di Torino. npalestini at molinette.piemonte.it)
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| Journal | Annali italiani di chirurgia
(Ann Ital Chir)
2005 Jan-Feb
Vol. 76
Issue 1
Pg. 13-8
ISSN: 0003-469X Italy |
| Vernacular Title | Trattamento chirurgico del morbo di basedow: risultati in 108 pazienti. |
| PMID | 16035666
(Publication Type: English Abstract, Journal Article)
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| Chemical References |
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| Topics |
- Follow-Up Studies
- Graves Disease
(complications, surgery)
- Humans
- Hypocalcemia
(etiology)
- Hypoparathyroidism
(complications, etiology)
- Retrospective Studies
- Thyroidectomy
(adverse effects, methods)
- Thyroxine
(administration & dosage)
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