title: Total thyroidectomy as a method of choice in the treatment of Graves' disease - analysis of 1432 patients.
abstract: BACKGROUND
  Graves' disease represents an autoimmune disease of the thyroid gland where surgery has an important role in its treatment. The aim of our paper was to analyze the results of surgical treatment, the frequency of microcarcinoma and carcinoma, as well as to compare surgical complications in relation to the various types of operations performed for Graves' disease.
  
  
  METHODS
  We analysed 1432 patients (221 male and 1211 female) who underwent surgery for Graves' disease at the Centre for Endocrine Surgery in Belgrade during 15 years (1996-2010). Average age was 34.8 years. Frequency of surgical complications within the groups was analyzed with nonparametric Fisher's test.
  
  
  RESULTS
  Total thyroidectomy (TT) was performed in 974 (68%) patients, and Dunhill operation (D) in 221 (15.4). Carcinoma of thyroid gland was found in 146 patients (10.2%), of which 129 (9%) were a microcarcinoma. Complication rates were higher in the TT group, where there were 31 (3.2%) patients with permanent hypoparathyroidism, 9 (0.9%) patients with unilateral recurrent nerve paralysis and 10 (1.0%) patients with postoperative bleeding. Combined complications, such as permanent hypoparathyroidism with bleeding were more common in the D group where there were 2 patients (0,9%), while unilateral recurrent nerve paralysis with bleeding was more common in the TT group where there were 3 cases (0,3%).
  
  
  CONCLUSIONS
  Frequency of complications were not significantly statistically different in relation to the type of surgical procedure. Total thyroidectomy represents a safe and efficient method for treating patients with Graves' disease, and it is not followed by a greater frequency of complications in relation to less extensive procedures.
authors.affiliation: Department for Endocrine Surgery and Breast Surgery, Clinic of General Surgery, Clinical Centre Nis, Bul. Dr Zorana Djindjica 48, 18000, Nis, Serbia. saskavalenta@sezampro.rs.
authors.forename: Toplica
authors.initials: T
authors.lastname: Bojic
authors.affiliation: Centre for Endocrine Surgery, Clinic of Endocrinology Diabetes and Metabolic Disease, Clinical Centre Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.|University of Belgrade School of Medicine, Dr Subotica 8, 11000, Belgrade, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Paunovic
authors.affiliation: Centre for Endocrine Surgery, Clinic of Endocrinology Diabetes and Metabolic Disease, Clinical Centre Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.|University of Belgrade School of Medicine, Dr Subotica 8, 11000, Belgrade, Serbia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Diklic
authors.affiliation: Centre for Endocrine Surgery, Clinic of Endocrinology Diabetes and Metabolic Disease, Clinical Centre Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.|University of Belgrade School of Medicine, Dr Subotica 8, 11000, Belgrade, Serbia.
authors.forename: Vladan
authors.initials: V
authors.lastname: Zivaljevic
authors.affiliation: Centre for Endocrine Surgery, Clinic of Endocrinology Diabetes and Metabolic Disease, Clinical Centre Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.
authors.forename: Goran
authors.initials: G
authors.lastname: Zoric
authors.affiliation: University of Belgrade School of Medicine, Dr Subotica 8, 11000, Belgrade, Serbia.|Centre for Anaesthesia and Resuscitation, Clinical Centre Serbia, Pasterova 2, 11000, Belgrade, Serbia.
authors.forename: Nevena
authors.initials: N
authors.lastname: Kalezic
authors.affiliation: University of Belgrade School of Medicine, Dr Subotica 8, 11000, Belgrade, Serbia.|Centre for Anaesthesia and Resuscitation, Clinical Centre Serbia, Pasterova 2, 11000, Belgrade, Serbia.
authors.forename: Vera
authors.initials: V
authors.lastname: Sabljak
authors.affiliation: Centre for Endocrine Surgery, Clinic of Endocrinology Diabetes and Metabolic Disease, Clinical Centre Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.
authors.forename: Nikola
authors.initials: N
authors.lastname: Slijepcevic
authors.affiliation: Centre for Endocrine Surgery, Clinic of Endocrinology Diabetes and Metabolic Disease, Clinical Centre Serbia, Dr Subotica 13, 11000, Belgrade, Serbia.
authors.forename: Katarina
authors.initials: K
authors.lastname: Tausanovic
authors.affiliation: Department for Endocrine Surgery and Breast Surgery, Clinic of General Surgery, Clinical Centre Nis, Bul. Dr Zorana Djindjica 48, 18000, Nis, Serbia.|University of Nis School of Medicine, Bul. Dr Zorana Djindjica 81, 18000, Nis, Serbia.
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Djordjevic
authors.affiliation: Department for Endocrine Surgery and Breast Surgery, Clinic of General Surgery, Clinical Centre Nis, Bul. Dr Zorana Djindjica 48, 18000, Nis, Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Budjevac
authors.affiliation: Department for Endocrine Surgery and Breast Surgery, Clinic of General Surgery, Clinical Centre Nis, Bul. Dr Zorana Djindjica 48, 18000, Nis, Serbia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Djordjevic
authors.affiliation: Department for Endocrine Surgery and Breast Surgery, Clinic of General Surgery, Clinical Centre Nis, Bul. Dr Zorana Djindjica 48, 18000, Nis, Serbia.|University of Nis School of Medicine, Bul. Dr Zorana Djindjica 81, 18000, Nis, Serbia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Karanikolic
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000150:complications / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome