Abstract | BACKGROUND: METHODS: RESULTS: We identified 78 patients (median age, 13.8 years; 87% female). The most common presenting signs and symptoms included heat intolerance (61%), decreased academic performance (50%), tremor (49%), and ophthalmopathy (43%). All patients had clinical and laboratory evidence of autoimmune thyrotoxicosis. Sixty-nine percent chose operative therapy because of failure of medical therapy or adverse drug reactions. Near-total thyroidectomy was the most common surgical procedure performed (65%). Pathology demonstrated previously unrecognized thyroid malignancies in 4 (5%) patients. Operative morbidities were transient and included hypoparathyroidism (6%) and recurrent laryngeal nerve neuropraxia (1%). Three (4%) patients who underwent subtotal thyroidectomy developed recurrent hyperthyroidism; all were treated successfully with radioiodine ablation. Of patients presenting with ophthalmopathy, 85% noted improvement postoperatively, while 1 (3%) patient experienced worsening of symptoms. Only 5% developed new-onset Graves ophthalmopathy after operation. CONCLUSIONS: Near-total thyroidectomy for Graves disease in children is safe and effective when performed by experienced thyroid surgeons. In addition to relief of systemic symptoms, the majority of patients presenting with Graves ophthalmopathy experienced improvement of their ocular disease after operation. In 5% of patients, surgical management allowed for detection and treatment of clinically occult thyroid malignancies.
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Authors | Jonathan Sherman, Geoffrey B Thompson, Aida Lteif, W Frederick Schwenk 2nd, Jon van Heerden, David R Farley, Seema Kumar, Donald Zimmerman, Marilyn Churchward, Clive S Grant |
Journal | Surgery
(Surgery)
Vol. 140
Issue 6
Pg. 1056-61; discussion 1061-2
(Dec 2006)
ISSN: 0039-6060 [Print] United States |
PMID | 17188157
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Child
- Child, Preschool
- Female
- Graves Disease
(complications, mortality, pathology, surgery)
- Graves Ophthalmopathy
(etiology, surgery)
- Humans
- Male
- Retrospective Studies
- Thyroidectomy
(adverse effects, methods)
- Treatment Outcome
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