Short- and long-term results of total vs subtotal thyroidectomies in the surgical treatment of Graves' disease
| Autor: | M Goumaz, Sophie Mariethoz, Jean-Claude Pache, B Jacot-des-Combes, John Robert, R Martin-Du Pan, A Peytremann, B Garcia, Daniel-Jean Bertin, A Burger, A Caulfield, Anastase Spiliopoulos, Nicolas Paul Henri Murith |
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| Jazyk: | angličtina |
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases Adolescent medicine.medical_treatment Graves' disease ddc:616.07 Thyroid Function Tests Teaching hospital Postoperative Complications Immunopathology medicine Humans Surgical treatment Aged Retrospective Studies Medical treatment ddc:617 business.industry Thyroid Thyroidectomy Long term results Middle Aged medicine.disease Graves Disease Graves Disease/surgery Surgery medicine.anatomical_structure Female Postoperative Complications/etiology business Follow-Up Studies |
| Zdroj: | Swiss Surgery, Vol. 7, No 1 (2001) pp. 20-4 |
| ISSN: | 1023-9332 |
| Popis: | Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare. |
| Databáze: | OpenAIRE |
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