title: Surgery for Graves' disease: a 25-year perspective.
abstract: BACKGROUND
  Optimal treatment of Graves' disease (GD) remains controversial. The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center.
  
  
  METHODS
  Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy over 25 years, in 3 periods: 1985 to 1993 (n = 32), 1994 to 2002 (n = 91), and 2003 to 2010 (n = 177).
  
  
  RESULTS
  There were 300 patients with GD (85.7% women; mean age, 39.3 years; median length of follow-up, 24.6 months). Overall, perioperative morbidity occurred in 36 patients (12.0%), and there was no mortality. Thyroidectomy-specific morbidity was very low, and the incidental malignancy rate was 10.3%.
  
  
  CONCLUSIONS
  Surgical treatment of GD has a very high safety profile, with low perioperative and thyroidectomy-specific morbidity, even in patients with overt hyperthyroidism. Incidental malignancy in patients with GD is not uncommon.
authors.affiliation: Thyroid Cancer Research Laboratory, Endocrine Surgery Unit, The Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street, Wang ACC 460, Boston, MA 02115, USA.
authors.forename: Roy
authors.initials: R
authors.lastname: Phitayakorn
authors.forename: Dieter
authors.initials: D
authors.lastname: Morales-Garcia
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wanderer
authors.forename: Carrie C
authors.initials: CC
authors.lastname: Lubitz
authors.forename: Randall D
authors.initials: RD
authors.lastname: Gaz
authors.forename: Antonia E
authors.initials: AE
authors.lastname: Stephen
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Ehrenfeld
authors.forename: Gilbert H
authors.initials: GH
authors.lastname: Daniels
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hodin
authors.forename: Sareh
authors.initials: S
authors.lastname: Parangi
mesh_terms: D055011:Ablation Techniques / Q000639:trends; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D004322:Drainage / Q000639:trends; D005260:Female; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D007902:Length of Stay / Q000639:trends; D008297:Male; D008404:Massachusetts; D008713:Methimazole / Q000627:therapeutic use; D061646:Operative Time; D011183:Postoperative Complications; D011300:Preoperative Care; D011441:Propylthiouracil / Q000627:therapeutic use; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000453:epidemiology; D013965:Thyroidectomy / Q000639:trends
chemical_list: D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D008713:Methimazole; D011441:Propylthiouracil
keywords: Graves’ disease; Incidental malignancy; Surgical therapy