[Is subtotal bilateral thyroidectomy still indicated in patients with Grave's disease?].
OBJECTIVE
To evaluate the morbidity and the functional results of subtotal bilateral thyroidectomy in patients (TST) with Graves' disease.


METHODS
A retrospective study was performed in 128 patients. They were 23 males and 105 females with a median age of 34 years (range: 14-68). Weight of remnant tissue was between 4 and 5 g. Thyroid functional status was evaluated, at 3 months and after a follow-up period ranged from 1 to 5 years, by measurement of serum concentration of free T4 and/or free T3 and TSH.


RESULTS
They were no post-operative death. Surgical complications were 2 vocal cord palsies and 17 hypocalcemia (inf. to 2 mmol/L). After a median follow-up of 2 years, they were no longer any cases of vocal cord dysfunction and no case of permanent hypoparathyroidism. Functional results were established in 118 patients: 46 patients had clinical hypothyroidism (39%), 64 patients had latent hypothyroidism or euthyroidism (54.2%), and 8 had recurrent hyperthyroidism (6.8%).


CONCLUSIONS
These results suggest that TST with a remnant mass inferior to 5 g provides a low level of recurrent hyperthyroidism and allows to give no drug therapy to half patients. In our opinion, TST is still indicated in Graves' disease.
Bilosi
M
M
Service de chirurgie générale et endocrinienne, hôpital général, CHU Dijon, rue du Faubourg-Raines, 21000 Dijon, France.
Binquet
C
C
Goudet
P
P
Lalanne-Mistrih
M L
ML
Brun
J M
JM
Cougard
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006111:Graves Disease / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000209:etiology