Abstract
BackgroundGraves’ disease represents an autoimmune disease of the thyroid gland where surgery has an important role in its treatment. The aim of our paper was to analyze the results of surgical treatment, the frequency of microcarcinoma and carcinoma, as well as to compare surgical complications in relation to the various types of operations performed for Graves’ disease.MethodsWe analysed 1432 patients (221 male and 1211 female) who underwent surgery for Graves’ disease at the Centre for Endocrine Surgery in Belgrade during 15 years (1996–2010). Average age was 34.8 years. Frequency of surgical complications within the groups was analyzed with nonparametric Fisher’s test.ResultsTotal thyroidectomy (TT) was performed in 974 (68%) patients, and Dunhill operation (D) in 221 (15.4). Carcinoma of thyroid gland was found in 146 patients (10.2%), of which 129 (9%) were a microcarcinoma. Complication rates were higher in the TT group, where there were 31 (3.2%) patients with permanent hypoparathyroidism, 9 (0.9%) patients with unilateral recurrent nerve paralysis and 10 (1.0%) patients with postoperative bleeding. Combined complications, such as permanent hypoparathyroidism with bleeding were more common in the D group where there were 2 patients (0,9%), while unilateral recurrent nerve paralysis with bleeding was more common in the TT group where there were 3 cases (0,3%).ConclusionsFrequency of complications were not significantly statistically different in relation to the type of surgical procedure. Total thyroidectomy represents a safe and efficient method for treating patients with Graves’ disease, and it is not followed by a greater frequency of complications in relation to less extensive procedures.
Highlights
Graves’ disease represents an autoimmune disease of the thyroid gland where surgery has an important role in its treatment
Graves’ disease (GD) represents an autoimmune disease of the thyroid gland, which is manifested by excessive production of hormones of the thyroid gland and is a common cause of hyperthyroidism
The aim of our work was to analyze the results of surgical treatment of patients with GD, the frequency of microcarcinoma and carcinoma in patients who underwent surgery for GD, as well as to compare surgical complications in relation to the various types of operations performed for GD
Summary
Graves’ disease represents an autoimmune disease of the thyroid gland where surgery has an important role in its treatment. Graves’ disease (GD) represents an autoimmune disease of the thyroid gland, which is manifested by excessive production of hormones of the thyroid gland and is a common cause of hyperthyroidism. GD is primarily treated by anti thyroid drugs, and only in the case of failure of this method of treatment are other types of therapy, such as the use of radioactive iodine, taken into account [1]. The rate of relapse after surgery is significantly lower than for treatment with radioiodine, or anti thyroid drugs [4,5]. Antithyroid drugs on one hand have good tolerance, but the rate of recurrence of hyperthyroidism is up to 69% after termination of the treatment [6].
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