A new method of subtotal thyroidectomy for Graves' disease leaving a unilateral remnant based on the upper pole.
BACKGROUND
The aim of this prospective randomized study was to evaluate the feasibility of subtotal thyroidectomy with leaving a unilateral remnant based on the upper pole.


METHODS
Patients who underwent the subtotal thyroidectomy and isthmusectomy leaving either a unilateral remnant based on the upper pole (Group I, 79 patients) or the bilateral dorsal thyroid tissue remained (Group II, 89 patients) were compared in operation time, blood loss, recurrence, and postoperative complications.


RESULTS
Among 168 patients analyzed, the operation time remained similar, but the blood loss, the reoperation time, and recurrence in Group I were much less than Group II. In addition, no postoperative hemorrhage occurred in Group I. Two patients (2.28%) in Group II underwent recurrent laryngeal nerve damages. Four patients (5.06%) in Group I and 3 patients (3.37%) in Group II experienced transient hypocalcemia. Recurrence only occurred in Group II.


CONCLUSIONS
In terms of blood loss, reoperation time, postoperative complication, and the recurrence, subtotal thyroidectomy with recurrent laryngeal nerves identification and the unilateral superior pole remnant of the gland provides a better outcome than subtotal thyroidectomy with bilateral dorsal thyroid tissue remnant.
Department of Thyroid and Breast Surgery Institute of Orthopedics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Yu
Y
Liu
Bin
B
Liu
Rui-Lei
RL
Liu
Hua
H
Jiang
Ze-Nan
ZN
Huang
Yong
Y
Huang
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012009:Recurrent Laryngeal Nerve; D013965:Thyroidectomy / Q000379:methods*