Long term follow-up of hyperthyroid patients treated by subtotal thyroidectomy

Abstract

The early and long term complications of subtotal thyroidectomy in 306 hyperthyroid patients (multinodular goitre and diffuse hyperplasia) followed for up to 30 yr are reviewed. There were no perioperative deaths. Sixteen patients (5.2 per cent) had transient symptomatic hypocalcaemia, while 9 (2.9 per cent) had permanent hypocalcaemia. Permanent unilateral vocal cord paralysis occurred in 11 (3.6 per cent) patients (1.8 per cent of nerves at risk). Cumulative per cent (+/- s.e.m.) relapse and hypothyroid rates at 30 yr (life-table analysis) were 15.6 +/- 2.4 per cent and 20.5 +/- 2.1 per cent, respectively. Lifelong follow-up of post-thyroidectomy patients is mandatory because of the risk of relapse of hypothyroidism.

The course of Graves' ophthalmopathy is not influenced by near total thyroidectomy: a case‐control study

“…Near‐total thyroidectomy was chosen as the surgical approach to treat hyperthyroidism due to Graves' disease as the recurrence rate after sub‐total thyroidectomy is not negligible ( Miccoli et al ., 1996 ) and may reach 20% ( Winsa et al ., 1995 ). The prevalence of permanent post‐operative complications after near‐total thyroidectomy reported by this group ( Miccoli et al ., 1996 ), and that observed in the present series, is no higher than that reported after sub‐total thyroidectomy ( Sugrue et al ., 1983 ; Menegaux et al ., 1993 ; Patwardhan et al ., 1993 ).…”

Graves' disease in children and adolescents. Late results of surgical treatment

“…The extent of the surgical procedure in any given patient with Graves' disease is still a question of debate (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39). in principle, surgery should be radical, espe¬ cially in young individuals, and it is a common experience that children under the age of 10 years may require total thyroidectomy to avoid the risk of recurrence.…”

The Surgical Management of Graves’ Disease

“…If one compares these potential disadvantages and risks to those of radioiodine therapy, one notes that hypothyroidism is a common result of radioactive iodine therapy [31], occurring in 20% of patients in the first year and increasing by 3 to 5% per year thereafter [5]. The risk of hypothyroidism after subtotal thyroidectomy varies depending on the amount of thyroid remnant left behind, but can arise in up to 60% of cases [8,23,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]. Thus, the risk of hypothyroidism should not play an important role in the decision making for either treatment for Graves' disease, because hypothyroidism is benign, easily treatable, and almost inevitable in both radioactive iodine therapy and thyroidectomy.…”