title: Near total thyroidectomy is an optimal treatment for graves' disease.
abstract: Surgical management of Graves' disease is still debated. We report our current experience with thyroidectomy for Graves' disease at a tertiary center. A retrospective database of 132 patients who underwent surgery for Graves' disease from January 1985 to December 2008 was collected. During that period, 16 patients underwent subtotal thyroidectomy and 116 patients underwent near total thyroidectomy. Eighty-seven patients (66%) underwent surgery for recurrent disease after medical therapy. Forty-five patients (34%) had surgery as a primary treatment, the indications were large goiter size in 22 (17%), patient preference in 19 (14%), and associated cold nodule in 3 (2%). The incidence of cancer was 4.4%. Permanent hypoparathyroidism was observed in one patient who underwent a second surgery for recurrence. Unilateral transitory vocal cord palsy was observed in nine patients (7%), bilateral transitory vocal cord palsy was observed in one patient, and no definitive vocal cord palsy was observed. Two patients (1.5%) experienced post-operative hemorrhagia requiring surgical revision. Near total thyroidectomy for Graves' disease provides an immediate and definitive treatment with a low complication rate. Near total thyroidectomy offers an appropriate treatment for coexisting malignancy. This procedure can be safely recommended as a primary treatment, in experienced hands.
authors.affiliation: Department of Thoracic, Head and Neck Surgery, Jules Bordet Institute, Free University of Brussels, 1000 Brussels, Belgium. antoine.digonnet@bordet.be
authors.forename: Antoine
authors.initials: A
authors.lastname: Digonnet
authors.forename: Esther
authors.initials: E
authors.lastname: Willemse
authors.forename: Cécile
authors.initials: C
authors.lastname: Dekeyser
authors.forename: Luc
authors.initials: L
authors.lastname: Vandevelde
authors.forename: Moreau
authors.initials: M
authors.lastname: Michel
authors.forename: Daniel
authors.initials: D
authors.lastname: Glinoer
authors.forename: Denis
authors.initials: D
authors.lastname: Larsimont
authors.forename: Guy
authors.initials: G
authors.lastname: Andry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006111:Graves Disease / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007011:Hypoparathyroidism / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011183:Postoperative Complications / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*; D014826:Vocal Cord Paralysis / Q000209:etiology; D055815:Young Adult