Document Detail


Results of subtotal thyroidectomy for Graves' disease.
MedLine Citation:
PMID:  10211601     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to find the factors responsible for hypothyroidism after subtotal thyroidectomy for Graves' disease. Two hundred five patients who were operated on from July 1989 to December 1997 were studied. The mean age of patients was 33.4+/-11.0 (mean +/- SD) years, and 175 (85.4%) were female. Patients were prepared with an antithyroid drug and Lugol's solution preoperatively. Triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyrotropin-binding immunoglobulins (TBII) antimicrosomal antibodies (AMA = 100x 4(M-1)), and antithyroglobulin antibodies (ATA = 100x4(T-1)) were measured 1 week before patients were operated on. Operations were performed according to the standard procedure with 2.5x1x1 cm of thyroid tissue remaining on each side before approximating the thyroid capsule and pretracheal fascia. Hypothyroidism was defined by patients with overt hypothyroidism in laboratory data, and or with T4 to maintain T3 and T4. Two hundred two patients were checked 3 months after being operated on. Latent hyperthyroidism was found in 22, euthyroidism in 55, latent hypothyroidism in 91, hypothyroidism in 34 (16.8%) and none were in overt hyperthyroidism. After a follow-up period of 26.9+/-15 (mean +/- SD) months, 199 patients were reevaluated. Overt hyperthyroidism was found in 2 patients, latent hyperthyroidism in 12, euthyroidism in 97, latent hypothyroidism in 72, and hypothyroidism in 16 (8%). Factors having possible effects on hypothyroidism after longterm follow-up were analyzed. Patient's age, gender, body surface, premedicative T3 and T4, preoperative ATA, and TBII, and the weight of removed thyroid had no effect on the occurrence of hypothyroidism. Preoperative AMA levels, and finding more than 10 lymphoid infiltrations per 10 low-power fields (x40) were significantly different between the hypothyroid and nonhypothyroid groups. A high level of preoperative AMA was the only factor independently causing overt hypothyroidism in the follow-up period. Patients with high preoperative AMA levels have a higher risk of hypothyroidism if only 2.5x1x1 cm remnants are left on each side.
Authors:
F F Chou; P W Wang; S C Huang
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  9     ISSN:  1050-7256     ISO Abbreviation:  Thyroid     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-12     Completed Date:  1999-07-12     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  253-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung Hsien, Taiwan, ROC. ChouLu@MS4.HINET.NET
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MeSH Terms
Descriptor/Qualifier:
Adult
Autoantibodies / blood
Female
Follow-Up Studies
Graves Disease / blood,  pathology,  surgery*
Humans
Male
Predictive Value of Tests
Thyroidectomy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Autoantibodies
Comments/Corrections
Comment In:
Thyroid. 1999 Mar;9(3):259-61   [PMID:  10211602 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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