| Extensive thyroidectomy in Graves' disease. | |
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MedLine Citation:
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PMID: 16735199 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The best surgical treatment for hyperthyroidism caused by Graves' disease remains a controversial subject. METHODS: Seven hundred fourteen consecutive patients underwent total or near-total thyroidectomy for Graves' disease in a 13-year period. In a first analysis, postoperative rates of suffocating hematoma, wound infection, recurrent laryngeal nerve (RLN) palsy, hypoparathyroidism, and persistence or recurrence of hyperthyroidism, were studied and compared with the same parameters in 4,426 patients who underwent bilateral thyroid gland resection for other conditions. A second analysis identified factors associated with postoperative complications among Graves' disease patients. RESULTS: Comparing Graves' disease patients with patients who had bilateral thyroid resection for other conditions, the transient morbidity rate was 13.3% versus 8.2% (p < 0.0001), with 10.2% versus 5.0% (p < 0.0001) hypoparathyroidism, 2.2% versus 1.7% (p = 0.35) RLN palsy, 1.7% versus 0.9% (p < 0.05) suffocating hematoma, and 0.3% versus 0.4% (p = 0.67) wound infection, respectively. Permanent morbidity rate was 2% versus 2.2% (p = 0.72), including 0.4% versus 0.6% RLN palsy and 1.5% versus 1.7% hypoparathyroidism. Among the Graves' disease patients, univariate analysis revealed that those who experienced postoperative complications had a higher weight resected thyroid gland (odds ratio = 1.5; 95% CI, 1.0-2.3) and a higher rate of total thyroidectomy (24.4% versus 19.5%, odds ratio = 2.2; 95% CI, 1.4-3.4) than patients without complications. In the multivariable model, these two factors remained independent. There was no recurrence of hyperthyroidism with a median followup of 6.7 years (interquartile range 4.1 to 10.1 years). Persistent hyperthyroidism developed in three patients. CONCLUSIONS: Total or near-total thyroidectomy is an effective and safe treatment for Graves' disease when performed by an experienced surgeon. |
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Authors:
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Sebastien Gaujoux; Laurence Leenhardt; Christophe Trésallet; Agnes Rouxel; Catherine Hoang; Christelle Jublanc; Jean-Paul Chigot; Fabrice Menegaux |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: 202 ISSN: 1072-7515 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-05-31 Completed Date: 2006-06-20 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: United States |
Other Details:
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Languages: eng Pagination: 868-73 Citation Subset: AIM; IM |
Affiliation:
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Department of General Surgery, Hôpital de la Pitié, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Follow-Up Studies Graves Disease / mortality, surgery* Humans Incidence Male Middle Aged Postoperative Complications / epidemiology Retrospective Studies Survival Rate Thyroidectomy / methods* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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