Total thyroidectomy is now the preferred option for the surgical management of Graves’ disease

Barakate, Michael S.; Agarwal, Gaurav; Reeve, T. S.; Barraclough, Bruce; Robinson, Bruce G.; Delbridge, Leigh

doi:10.1046/j.1445-2197.2002.02400.x

Cited by 93 publications

(69 citation statements)

References 22 publications

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“…Analyzing our series of patients we did not find any significant differences in relation to gender in comparison to other authors [13,16] . The average age of the patients was 29 years (15 to 75) which is slightly higher than data available in literature [2,16] . In the US, the number of patients with GD that are surgically treated is small.…”

Section: Resultscontrasting

confidence: 77%

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Total Thyroidectomy for Graves’ disease – Our Experience

Hussain¹

2017

JMSCR

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Section: Resultscontrasting

confidence: 77%

“…Due to a relatively low rate of complications for TT, com-pared to less extensive procedures, many authors recom-mended TT as the treatment of choice for GD [16,[19][20][21] . In our study the most common indication for surgery was thyromegaly (80%), followed by ophthalmopathy and ultrasound diagnosed thyroid nodule >1 cm (10%).…”

Section: Resultsmentioning

confidence: 99%

Total Thyroidectomy for Graves’ disease – Our Experience

Hussain¹

2017

JMSCR

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“…26,27 Nevertheless, the above approach has recently been challenged by endocrine surgeons who support total thyroidectomy and have demonstrated better control of thyroid disease and even comparable morbidity to subtotal thyroidectomy. [28][29][30][31] Due to these encouraging reports, total thyroidectomy has gained acceptance among the surgeons of our institution and over the last few years it has rapidly displaced the more conservative surgical approaches.…”

Section: Discussionmentioning

confidence: 99%

Complications and risk factors related to the extent of surgery in thyroidectomy. Results from 2,043 procedures

Karamanakos¹,

Markou²,

Panagopoulos³

et al. 2010

128

117

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OBJECTIVE: To evaluate the rate of complications and the risk factors in relation to the extent of surgery in patients undergoing thyroidectomy in a tertiary university center. DESIGN: Data were collected retrospectively from 2,043 consecutive patients who underwent thyroid surgery for various thyroid diseases at the University Hospital of Patras, Greece, between January 1996 and December 2007. recurrent laryngeal nerve palsy (rLNP) and hypoparathyroidism were set as the primary end points, while hematoma and wound infection were set as the secondary endpoints. rESULTS: Total, near-total and subtotal thyroidectomy was performed in 1,149, 777 and 117 patients, respectively. Transient rLNP occurred in 34 (1.6%) and permanent in 19 (0.9%) patients. Multivariate logistic regression analysis showed that extended resection (Or-odds ratio-1.6), Graves' disease (Or 2.7), thyroiditis (Or 2.1), recurrent goiter (Or 2.3) and thyroid malignancy (Or 1.7) were all independent risk factors for transient rLNP, whereas Graves' disease (Or 2.2) and recurrent goiter (Or 1.7) emerged as independent risk factors for permanent rLNP. The rates of transient and permanent hypoparathyroidism were 27.8% and 4.8%, respectively. Multivariate analysis for transient hypoparathyroidism revealed that the extent of surgical resection (Or 2.2), Graves' disease (Or 2.1), recurrent goiter (Or 1.7), female gender (Or 1.5) and specimen weight (Or 1.6) were independent predictors. However, the extent of surgical resection (Or 2.7), Graves' disease (Or 1.8), recurrent goiter (Or 1.5) and malignant disease (Or 1.5) were independent risk factors for permanent hypoparathyroidism. Postoperative wound infection and hematoma occurred in 6 (0.3%) and 27 (1.3%) patients, respectively. No correlation was observed between wound infection or postoperative hemorrhage and the extent of surgery. CONCLUSIONS: Despite the higher morbidity, total thyroidectomy is emerging as an attractive surgical option even for benign thyroid disease due to the risk of subclinical (occult) malignancy, the possibility of goiter relapse as well as of the increased risk of complications following reoperation.

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“…Importantly, it has been shown that the morbidity and cosmetic impact of cervical incision after total thyroidectomy are comparable to those of subtotal thyroidectomy. [7][8][9] Recently, minimally invasive surgery has been successfully used for the treatment of both benign and malignant thyroid disorders. The well-known advantages of this approach are the reduced postoperative pain, improved cosmesis (patients are usually young females), shorter hospital stay, and lower costs.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of minimal‐incision thyroidectomy for Graves' disease: A prospective, single‐center study

et al. 2012

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Background. The role of minimally invasive surgery in Graves' disease is still controversial. The aim of this study was to compare the clinical outcomes of patients undergoing minimal-incision thyroidectomy with those undergoing conventional thyroidectomy for Graves' disease. Methods. A prospective study was performed on 148 patients undergoing total thyroidectomy. Seventy-one patients underwent minimal-incision thyroidectomy and 77 underwent conventional thyroidectomy. Minimal-incision thyroidectomy was proposed if the thyroid volume was 50 mL.Results. There were no significant differences in the operative time between minimal-incision thyroidectomy and conventional thyroidectomy. The length of skin incision was significantly shorter in the minimal-incision thyroidectomy than that in the conventional thyroidectomy group. The incidence of postoperative complications was similar in the 2 groups. Patients undergoing minimal-incision thyroidectomy experienced significantly less postoperative pain and were more satisfied with the cosmetic result than patients who underwent conventional thyroidectomy. Conclusions. Minimal-incision thyroidectomy is a feasible and safe option for the surgical treatment of selected patients with Graves' disease.

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Total thyroidectomy is now the preferred option for the surgical management of Graves’ disease

Cited by 93 publications

References 22 publications

Total Thyroidectomy for Graves’ disease – Our Experience

Total Thyroidectomy for Graves’ disease – Our Experience

Complications and risk factors related to the extent of surgery in thyroidectomy. Results from 2,043 procedures

Feasibility and safety of minimal‐incision thyroidectomy for Graves' disease: A prospective, single‐center study

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