[Surgery for hyperthyroidism. Results and current trends].
From 1974 to 1990, the same surgeon operated 96 cases of hyperthyroidism: 72 cases of Basedow's disease, and 24 basedoid goiters. The preliminary preparation with antithyroid agents, sedation, Lugol and beta-blockers is particularly important, as is rehydration, high-dose sedation and beta-blockers, if required, during the postoperative period. There are few complications: 1 hematoma, 1 permanent unilateral laryngeal paralysis, 1 permanent hypocalcemia, 5 transient psychical and/or cardiac disorders, 1 malignant exophthalmia. There was no thyrotoxic crisis. Long-term follow-up allows nothing 4 recurrences as well as hypothyroidism in 46% of all cases. The size of the thyroid remains left in place is closely related to hypothyroidism. One case of vesiculo-papillary carcinoma is noted among the 24 cases of basedoid goiters (4.5%), which justifies total thyroidectomy in such cases. There also was one papillary carcinoma among the 72 patients with Basedow's disease (1.3%).
Gras
R
R
Service d'ORL, CHU Timone, Marseille.
Cannoni
M
M
Verdalle
P
P
Zanaret
M
M
Dessi
P
P
D013956:Antithyroid Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy / Q000601:surgery*; D006996:Hypocalcemia / Q000209:etiology; D011183:Postoperative Complications; D012008:Recurrence; D013964:Thyroid Neoplasms / Q000473:pathology; D013965:Thyroidectomy
D013956:Antithyroid Agents
La chirurgie de l'hyperthyroïdie. Résultats et orientations actuelles.