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Article: Total thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves' disease

TitleTotal thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves' disease
Authors
KeywordsComplication
Follow up
Graves' disease
Recurrence
Subtotal thyroidectomy
Total thyroidectomy
Issue Date2005
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ANS
Citation
Anz Journal Of Surgery, 2005, v. 75 n. 7, p. 528-531 How to Cite?
AbstractBackground: Total thyroidectomy is increasingly being adopted for patients requiring surgical treatment for Graves' disease based on a comparable surgical risk and the lack of recurrence, as well as the questionable ability of subtotal thyroidectomy to maintain euthyroidism. The purpose of the present paper was to evaluate its safety and efficiency. Methods: Total thyroidectomy was adopted as part of the routine surgical treatment for Graves' disease from 2000. Patients who underwent subtotal thyroidectomy (STT) from 1995 to 1999 (n = 119) were compared with those who underwent total thyroidectomy (TT) from 2000 to 2003 (n = 98) with respect to immediate postoperative morbidity and long-term outcome. Results: Fourteen (11.8%) and 22 patients (22.4%) required calcium supplement on discharge in the STT and TT groups, respectively (P < 0.05). One (0.8%) and three patients (3.1%) developed permanent hypocalcaemia, respectively. Transient recurrent laryngeal nerve palsy occurred in 9.2% (n = 11) and 5.1% (n = 5) of patients or 5.0% and 2.6% of nerves at risk after STT and TT, respectively. None of the patients had permanent nerve palsy. The estimated blood loss was less and hospital stay shorter after TT. During a mean follow up of 64 months, 86 patients (72.3%) in the STT group required thyroxine replacement and seven patients (5.9%) developed relapse. Conclusion: Subtotal thyroidectomy was associated with relapse as well as hypothyroidism in a significant proportion of patients during long-term follow up. Total thyroidectomy can be performed as safely as STT and should be recommended as the procedure of choice for patients requiring surgical treatment for Graves' disease.
Persistent Identifierhttp://hdl.handle.net/10722/77982
ISSN
2015 Impact Factor: 1.158
2015 SCImago Journal Rankings: 0.432
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKu, CFen_HK
dc.contributor.authorLo, CYen_HK
dc.contributor.authorChan, WFen_HK
dc.contributor.authorKung, AWCen_HK
dc.contributor.authorLam, KSLen_HK
dc.date.accessioned2010-09-06T07:37:52Z-
dc.date.available2010-09-06T07:37:52Z-
dc.date.issued2005en_HK
dc.identifier.citationAnz Journal Of Surgery, 2005, v. 75 n. 7, p. 528-531en_HK
dc.identifier.issn1445-1433en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77982-
dc.description.abstractBackground: Total thyroidectomy is increasingly being adopted for patients requiring surgical treatment for Graves' disease based on a comparable surgical risk and the lack of recurrence, as well as the questionable ability of subtotal thyroidectomy to maintain euthyroidism. The purpose of the present paper was to evaluate its safety and efficiency. Methods: Total thyroidectomy was adopted as part of the routine surgical treatment for Graves' disease from 2000. Patients who underwent subtotal thyroidectomy (STT) from 1995 to 1999 (n = 119) were compared with those who underwent total thyroidectomy (TT) from 2000 to 2003 (n = 98) with respect to immediate postoperative morbidity and long-term outcome. Results: Fourteen (11.8%) and 22 patients (22.4%) required calcium supplement on discharge in the STT and TT groups, respectively (P < 0.05). One (0.8%) and three patients (3.1%) developed permanent hypocalcaemia, respectively. Transient recurrent laryngeal nerve palsy occurred in 9.2% (n = 11) and 5.1% (n = 5) of patients or 5.0% and 2.6% of nerves at risk after STT and TT, respectively. None of the patients had permanent nerve palsy. The estimated blood loss was less and hospital stay shorter after TT. During a mean follow up of 64 months, 86 patients (72.3%) in the STT group required thyroxine replacement and seven patients (5.9%) developed relapse. Conclusion: Subtotal thyroidectomy was associated with relapse as well as hypothyroidism in a significant proportion of patients during long-term follow up. Total thyroidectomy can be performed as safely as STT and should be recommended as the procedure of choice for patients requiring surgical treatment for Graves' disease.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ANSen_HK
dc.relation.ispartofANZ Journal of Surgeryen_HK
dc.rightsThe definitive version is available at www3.interscience.wiley.com-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectComplicationen_HK
dc.subjectFollow upen_HK
dc.subjectGraves' diseaseen_HK
dc.subjectRecurrenceen_HK
dc.subjectSubtotal thyroidectomyen_HK
dc.subjectTotal thyroidectomyen_HK
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshGraves Disease - surgery-
dc.subject.meshPostoperative Complications-
dc.subject.meshThyroidectomy - methods-
dc.titleTotal thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves' diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1445-1433&volume=75&issue=7&spage=528&epage=531&date=2005&atitle=Total+thyroidectomy+replaces+subtotal+thyroidectomy+as+the+preferred+surgical+treatment+for+Graves%27+diseaseen_HK
dc.identifier.emailKung, AWC:awckung@hku.hken_HK
dc.identifier.emailLam, KSL:ksllam@hku.hken_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.identifier.authorityLam, KSL=rp00343en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1111/j.1445-2197.2005.03441.xen_HK
dc.identifier.pmid15972039en_HK
dc.identifier.scopuseid_2-s2.0-22344456326en_HK
dc.identifier.hkuros98469en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-22344456326&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume75en_HK
dc.identifier.issue7en_HK
dc.identifier.spage528en_HK
dc.identifier.epage531en_HK
dc.identifier.isiWOS:000229783500007-
dc.publisher.placeAustraliaen_HK
dc.identifier.scopusauthoridKu, CF=7101950635en_HK
dc.identifier.scopusauthoridLo, CY=16417392800en_HK
dc.identifier.scopusauthoridChan, WF=7403918455en_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.scopusauthoridLam, KSL=8082870600en_HK

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