Is euthyroidism the goal of surgical treatment of diffuse toxic goitre?
OBJECTIVE
To find out by studying a homogeneous group of patients whether euthyroidism is achievable by surgical treatment of diffuse toxic goitre.


METHODS
Retrospective study.


METHODS
Teaching hospital, Italy.


METHODS
128 of the 152 patients operated on for diffuse toxic goitre during the period January 1971-December 1994 and followed up for a median of 83 months (range 6-289). INTERVENTION. Standard subtotal thyroidectomy.


METHODS
Operative mortality, recurrence, hypothyroidism and late complications.


RESULTS
There were no operative deaths. After 10 years follow up, 11 patients (9%) had developed recurrences and 61 (48%) were euthyroid. In the univariate analysis the risk of hypothyroidism was significantly associated with the year of operation (p = 0.04), the duration of symptoms (p < 0.01), and the degree of lymphocytic infiltration (p < 0.01). The last two were confirmed by multivariate analysis.


CONCLUSIONS
Subtotal thyroidectomy seems to be an effective treatment of diffuse toxic goitre as a stable euthyroid state can be achieved in nearly half the patients after a prolonged follow up.
Istituto di Clinica Chirurgica, Università degli Studi di Genova, Italy.
G
G
Torre
G
G
Borgonovo
A
A
Arezzo
M
M
Costantini
E
E
Varaldo
G L
GL
Ansaldo
F P
FP
Mattioli
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000401:mortality; D016896:Treatment Outcome