Document Detail


Role of surgery in the management of Graves' disease.
MedLine Citation:
PMID:  11676109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Seventy-two patients, 50 women and 22 men, were operated on for Graves' disease. Their median age was 35 years. The indications for surgery included patients with large goitre, relapse after antithyroid drug (ATD) therapy, allergic reactions to ATD, non-compliance and finally an associated nodule with suspicion of carcinoma. Patients were rendered euthyroid with ATD before surgery and were pretreated with Lugol's iodine. Standard subtotal thyroidectomy was performed in 64 patients, total thyroidectomy in 7 patients, and one patient underwent a completion thyroidectomy after an initial subtotal thyroidectomy. The weight of the thyroid remnant on either side was estimated emperically between 3 g and 5 g. There was no postoperative death or thyrotoxic crisis. There was no case of permanent recurrent laryngeal nerve damage or hypoparathyroidism. Eight patients (11.1%) had temporary unilateral vocal cord palsy and 4 patients (5.5%) had temporary hypocalcemia. One patient (1.4%) developed recurrent hyperthyroidism. Postoperative transient hypothyroidism developed in 87.5% cases, all within the first postoperative year. The functional results at 2 years were as follows: Out of 47 cases followed 31 patients (65.9%) became euthyroid while 15 (31.9%) were still hypothyroid and requited long term substitutive treatment. Ophthalmopathy worsened in only one patient. Thyroidectomy has reasonable role in the management of Graves' disease, because the patients have had their diseases rapidly terminated, were hospitalised for an average period of only 3.5 days and have had no permanent functional insult except for hypothyroidism.
Authors:
A Agarwal; S K Mishra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Indian Medical Association     Volume:  99     ISSN:  0019-5847     ISO Abbreviation:  J Indian Med Assoc     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-10-24     Completed Date:  2001-12-04     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7505608     Medline TA:  J Indian Med Assoc     Country:  India    
Other Details:
Languages:  eng     Pagination:  252, 254-6     Citation Subset:  IM    
Affiliation:
Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Female
Graves Disease / surgery*
Humans
Hypothyroidism / etiology
Male
Middle Aged
Thyroidectomy* / adverse effects

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