An analytic comparison of different thyroidectomy techniques for Graves' disease

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  • IIDA Yutaka
    Department of Surgery, Japanese Red Cross Gifu Hospital

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  • バセドウ病に対する手術術式の比較検討
  • バセドウビョウ ニ タイスル シュジュツジュツシキ ノ ヒカク ケントウ

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Abstract

The purpose of our study was to compare different thyroidectomy techniques for patients with Graves' disease. A total of 124 consecutive patients with Graves' disease underwent thyroid surgery between January 2000 and April 2012 at our hospital. Preoperative, intraoperative, and postoperative variables were analyzed. Reasons for thyroid surgery included : persistent disease despite medical therapy (52%), side effects of medical therapy (33%), ophthalmopathy (8%), multinodular goiter or cold nodules (6%), and patient preference (1%). A total of 124 surgeries was performed : 30.6% (n = 38) were subtotal thyroidectomies (ST), 33.9% (n = 42) were super-subtotal thyroidectomies (SST), and 35.5% (n = 44) were total thyroidectomies (TT). The average gland weight for ST, SST, and TT was 109.4 g, 80.5 g, 88.9 g, respectively. There was no difference in the operative time or the postoperative complication rates (recurrent laryngeal nerve palsy, postoperative bleeding, and tetany). Recurrences occurred in 10.5% of the ST group and 4.8% of the SST group. TT for patients with Graves' disease can be performed safely compared to ST or SST, and there is almost no risk of recurrence. Therefore, TT is recommended for the surgical treatment of Graves' disease.

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