title: Thyroid function after subtotal thyroidectomy in patients with Graves' hyperthyroidism.
abstract: BACKGROUND
  Subtotal thyroidectomy is a surgical procedure, in which the surgeon leaves a small thyroid remnant in situ to preserve thyroid function, thereby preventing lifelong thyroid hormone supplementation therapy.
  
  
  OBJECTIVE
  To evaluate thyroid function after subtotal thyroidectomy for Graves' hyperthyroidism.
  
  
  METHODS
  We retrospectively reviewed the medical records of all patients (n = 62) who underwent subtotal thyroidectomy for recurrent Graves' hyperthyroidism between 1992 and 2008 in our hospital. Thyroid function was defined according to plasma TSH and free T4 values.
  
  
  RESULTS
  Median followup after operation was 54.6 months (range 2.1-204.2 months). Only 6% of patients were euthyroid after surgery. The majority of patients (84%) became hypothyroid, whereas 10% of patients had persistent or recurrent hyperthyroidism. Permanent recurrent laryngeal nerve palsy and permanent hypocalcaemia were noted in 1.6% and 3.2% of patients, respectively.
  
  
  CONCLUSIONS
  In our series, subtotal thyroidectomy for Graves' hyperthyroidism was associated with a high risk of postoperative hypothyroidism and a smaller, but significant, risk of persistent hyperthyroidism. Our data suggest that subtotal thyroidectomy seems to provide very little advantage over total thyroidectomy in terms of postoperative thyroid function.
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. e.j.limonard@amc.uva.nl
authors.forename: E J
authors.initials: EJ
authors.lastname: Limonard
authors.forename: P H
authors.initials: PH
authors.lastname: Bisschop
authors.forename: E
authors.initials: E
authors.lastname: Fliers
authors.forename: E J
authors.initials: EJ
authors.lastname: Nieveen van Dijkum
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006111:Graves Disease / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013960:Thyroid Function Tests; D013965:Thyroidectomy; D055815:Young Adult