Management of Grave’s Disease Is Improved by Total Thyroidectomy

Abstract

Change from ST to TT dramatically reduced the risk for recurrence of GD without increasing the rate of complications. TT is not more effective than ST in hampering progression of DO as has been advocated by some. Careful surgical dissection up to the hyoid bone is necessary to avoid recurrence.

Total thyroidectomy vs bilateral subtotal thyroidectomy in patients with Graves’ diseases: a meta‐analysis of randomized clinical trials

“…In the present meta‐analysis, we found a significant reduction in recurrent hyperthyroidism, which was observed in TT patients comparing with ST patients. Thus, it seems that leaving any tissue could be a risk of recurrence just as some endocrine surgeons believe …”

“…Thus, it seems that leaving any tissue could be a risk of recurrence just as some endocrine surgeons believe. 22,23 Graves' ophthalmopathy is an autoimmune inflammatory disorder affecting the orbit around the eye, characterized by upper eyelid retraction, oedema, erythema, conjunctivitis and proptosis. 24 Although the role of thyrotrophin-binding inhibitory immunoglobulin in GO is widely accepted, the exact mechanism of ophthalmopathy remains unclear.…”

The choice of surgery in patients with diffuse toxic goiter

“…Пре-жде всего это связано с различными взглядами на цель оперативного пособия при этом заболевании [1,2,10,15]. Дискуссии ведутся в отношении двух операций -субтотальной резекции щитовидной железы и тиреоидэктомии.…”

“…Дискуссии ведутся в отношении двух операций -субтотальной резекции щитовидной железы и тиреоидэктомии. Так, в нашей стране многие хирурги продолжают активно применять ме-тодику субтотальной резекции щитовидной железы при оперативном лечении больных ДТЗ [1,5,10,15]. Считается, что при выполнении этой операции остающаяся масса ткани железы не должна превы-шать 2-6 г. По мнению большинства авторов, это позволяет избежать развития рецидива тиреотокси-коза в послеоперационном периоде [1,10,16,17], но уже доказано, что при таком подходе у 10-30% больных выполнение органосохраняющих опера-ций сопровождается развитием рецидива тиреоток-сикоза [4,7,12,21].…”

Thyroid thyrothymic extension: An anatomic study in a surgical series

“…Indications for thyroidectomy include treatment of thyroid cancer, diagnosis of indeterminate thyroid nodules, treatment of symptomatic multinodular goiters, and surgical treatment of hyperthyroidism. In the past, subtotal thyroidectomy was a commonly performed operation, however, there has been an increasing shift away from subtotal and toward total thyroidectomy for treatment of thyroid cancer, multinodular goiter, and Graves disease …”