Sixty four patients with hyperthyroidism operated upon at the Department of Surgery, Dong Kang Hospital, Ulsan from October 1983 through July 1992, were analyzed retrospectively for the postoperative complications according to the histologic type
and
operative method.
The relative incidence of hyperthyroidism among total 439 cases of thyroid disease operated during the same period was 15%. The median age at presentation was 31 years(range, 16 to 57 years) and the male to female ratio was 1:4. Indications of
operation
were cosmesis in young patients with large goiter in 42 cases (66%), medical intractability in 11 cases (17%), compression symptom in 10 cases (15%), etc. Fifty five cases(86%) underwent bilateral subtotal lobectomy (BSL group) and 9 cases (14%)
unilateral total lobectomy with contralateral subtotal lobectomy (UTL with CSL group). Total remnant thyroid tissue was around 3 to 6 gm in weight. Graves' disease was 46 cases (72%), Hashimoto's thyroiditis 17 cases (26%) and toxic adenoma 1
case(2%).
Postoperative complications occurred in 15 cases (23%). The incidence of recurrent hyperthyroidism was higher than that of hypothyrodism (9% vs 2%). Other complications were transient hypoparathyroidism in 3 cases (5%), recurrent laryngeal nerve
paralysis in 1 cases (2%), wound bleeding and infection 4 cases(6%) respectively.
There was no difference in complication rate between histologic types, but most of complications including 6 cases of recurrent hyperthyroidism were occurred in BSL group except one case of permanent hypothyroidism in UTL with CSL group.
These results suggest that operative method in hyperthyroidism should be designed to decrease the recurrence of hyperthyroidism and so unilateral total lobectomy with contralateral subtotal lobectomy rather than bilateral subtotal lobectomy may
be
better choice.
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