Graves’ Disease: What Is the Role and Timing of Surgery?

Degree of technical difficulty of thyroidectomy for autoimmune thyroid disease

“…Surgery may be recommended for compressive symptoms and in some cases clinical concern for malignancy . Graves' Disease (GD) is the most common cause of hyperthyroidism, accounting for more than 80% of cases . Surgical management, which was previously reserved for patient's failing medical treatment, has experienced increasing interest as a first‐line treatment for GD .…”

“…These changes have been noted in patients with autoimmune and inflammatory thyroid disorders such as HT and GD, which has led to recent research questioning the safety of thyroidectomy in this patient population, especially without evidence of malignancy . It has been demonstrated that removal of the thyroid is more technically challenging when underlying inflammation is present . The inflamed thyroid gland may become adherent to critical adjacent structures including the parathyroid glands and recurrent laryngeal nerve .…”

“…It has been demonstrated that removal of the thyroid is more technically challenging when underlying inflammation is present . The inflamed thyroid gland may become adherent to critical adjacent structures including the parathyroid glands and recurrent laryngeal nerve . Accordingly, complication rates may be increased in this patient population, especially when performed at low and intermediate‐volume settings …”