Does thyroid surgery for Graves’ disease improve health-related quality of life?

Abstract

Purpose Graves' disease can induce alterations of the psychosocial well-being that negatively influence the overall well-being of patients. Among the current treatments, surgery has limited indications, and its impact on the health-related quality of life has not been well clarified. The aim of this study was to assess the impact of surgery on the quality of life. Methods Fifty-seven patients who underwent total thyroidectomy for Graves' disease in our surgical unit between April 2002 and December 2009 were administered a questionnaire concerning four issues: organic alterations and clinical manifestations, neurovegetative system disturbances, impairment of daily activities, psychosocial problems. Patients were retrospectively questioned after thyroidectomy about the presence of these symptoms in both the pre and postoperative periods. Results There was a significant improvement after surgery in all four areas. Organic manifestations and psychosocial problems had higher average improvements, as did some aspects of the neurovegetative system and difficulties in undertaking daily activities. There were no reports of a worsening of symptoms. Conclusions Surgery resolved the hyperthyroidism in 100 % of cases, and was associated with a quality of life improvement of about 70 % in the patients. Surgery can therefore provide an immediate and effective resolution of Graves' disease, with benefits in health-related quality of life.

The coexistence of primary hyperparathyroidism and thyroid nodules: should the preoperative work-up of the parathyroid and the thyroid diseases be specifically adjusted?

“…When a contemporaneous thyroid surgery is indicated, the total thyroidectomy subject to the informed consent is the procedure of choice, considering that it is well tolerated and efficacious for a wide range of situations (50)(51)(52)(53).…”

The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

“…The following exclusion criteria were used in this study: thyroid carcinoma (except low-risk papillary microcarcinoma) (seven patients), Graves' disease due to its negative impact on health-related QoL [14,15], chronic anemia (including thalassemia), chronic disease (cardiac, pulmonary, hepatic, renal) in advanced stage, type 1 diabetes mellitus or type 2 diabetes requiring insulin treatment for control, inflammatory bowel diseases, hyperparathyroidism, functional adrenal diseases, personal history of cancer, and all diseases interfering with performance status. Chronic diseases were evaluated in all study periods.…”

Surgical treatment of Graves disease

“…It is safe to say that, despite the impression that hypocalcemia and hematomas are more frequent after toxic goiter surgery than normal thyroid operations, this effectively does not occur. Scerrion et al 9 demonstrated not only success in the resolution of hyperthyroidism, but also a real improvement in quality of life.…”