Prediction of Hypothyroidism after Partial Thyroidectomy for Thyrotoxicosis

Michie, W.; Pegg, C. A. S.; Bewsher, P. D.

doi:10.1136/bmj.1.5791.13

Cited by 74 publications

(28 citation statements)

References 15 publications

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“…Bereits in den 70er Jahren konnte gezeigt werden, dab zwischen der Gr6Be der operativ belassenen Restschilddrfise und der Rate postoperativer Hyperthyreosen bzw. Hypothyreosen eine direkte Korrelation besteht [10,25,35].…”

Section: Surgical Treatment Of Graves' Diseaseunclassified

Operatives Therapiekonzept der Immunthyreopathie

Dralle

Schober

Hesch

1987

Langenbecks Arch Chiv

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73 patients with Graves' disease, surgically treated from 1975-1986, were investigated retrospectively. 43 patients, treated by subtotal thyroidectomy (Enderlen-Hotz) and a bilateral thyroid remnant of a total of about 8-12 g, were compared with 30 patients, treated by a modified subtotal thyroidectomy leaving a unilateral thyroid remnant of about 4-8 g, with respect to preoperative duration of disease, indications for surgical treatment, weight of resected specimens, operative complications and postoperative thyroid function. Surgical complications were similar in both groups. After subtotal thyroidectomy 14/43 patients (33%) displayed either recurrent hyperthyroidism (9/43, 21%) or local recurrence of Graves' goiter (3/43, 7%) or both (2/43, 5%). The modified subtotal resected group showed no recurrences of the disease. After subtotal thyroidectomy 11 patients were euthyroid without thyroid medication (26%) compared to only two patients (7%) after the modified procedure of subtotal thyroid resection. To prevent recurrences of goiter as well as hyperthyroidism and, on the other hand, to achieve euthyroid function postoperatively without need for thyroid replacement therapy, subtotal thyroidectomy with a small thyroid remnant of about 4-8 g is recommended for all patients with large goiter and a chronic recurrent course of the disease or with iodine induced thyrotoxicosis. Patients with non-recurrent Graves' disease but large goiter probably benefit from subtotal thyroidectomy with a larger thyroid remnant of about 8-12 g.

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Section: Surgical Treatment Of Graves' Diseaseunclassified

Operatives Therapiekonzept der Immunthyreopathie

Dralle

Schober

Hesch

1987

Langenbecks Arch Chiv

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“…The commonest complication of both methods of destructive therapy is hypothyroidism, though the time interval and incidence differ considerably in each. Provided that an adequate remnant is left, the hypothyroid rate I year after operation is in the region of 30 per cent, and if the index of clinical suspicion during this year is sufficiently high, hypothyroidism will rarely develop later than I year after operation (Michie, Pegg, and Bewsher, 1972). In contrast, the hypothyroid rate after radioiodine therapy has been recorded as high as 41 per cent at I year, with an annual increase thereafter of 2.8 per cent (Nofal, Beierwaltes, and Patno, 1966).…”

Section: Aberoeen Royal Infirmarymentioning

confidence: 99%

Symposium on modern trends in the management of thyrotoxicosis. Opening address

Michie

1973

Journal of British Surgery

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“…post-operative thyroid status. Among these, the size of the thyroid gland remnant is considered to be the main prognostic determinant and it is generally agreed that thyroid gland remnants that are too small or too large cause post-operative hypothyroidism and hyperthyroidism, respectively [1][2][3], but the optimum size of the thyroid gland remnant which causes all patients to be euthyroid after surgery has not yet been determined [4][5][6][7]. Noguchi et al reported that the post-operative status could not be determined by the weight of the present thyroid gland remnant [8].…”

Section: Introductionmentioning

confidence: 99%

Post-Operative Thyroid Status of Patients with Graves' Disease Is Determined by the Responsiveness of Thyrocyte to TSH under the Present Thyroid Gland Remnant.

et al. 1998

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Abstract.In order to determine whether thyrocyte responsiveness to TSH is correlated with postoperative thyroid status, thyrocytes obtained from 51 patients with Graves' disease were cultured for 3 days. This was followed by culture with 10 mU/mL of TSH (TSH group) or without TSH (control group) for 3 additional days. On the 8th culture day, the amount of thyroglobulin (Tg) secreted into the culture medium was assayed and the Tg ratio (amount of Tg from the stimulated group/amount of TG from the control group) was calculated.Logio (the Tg ratio) was used for the statistic study.

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Prediction of Hypothyroidism after Partial Thyroidectomy for Thyrotoxicosis

Cited by 74 publications

References 15 publications

Operatives Therapiekonzept der Immunthyreopathie

Operatives Therapiekonzept der Immunthyreopathie

Symposium on modern trends in the management of thyrotoxicosis. Opening address

Post-Operative Thyroid Status of Patients with Graves' Disease Is Determined by the Responsiveness of Thyrocyte to TSH under the Present Thyroid Gland Remnant.

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