To compare the therapeutic results of serveral resection modalities for the surgical management of Graves' disease, we retrospectively analyzed 67 consecutive patients underwent surgical treatments at the Chonnam University Hospital.
These patient were divided into four groups according to resection methods: group A consisted of those who underwent hemithyroidectomy plus subtotal resection of contralateral lobe with an upper pole tissue retained; group B, hemithyroidectomy
plus
contralateral resection with lower pole retained; group C, bilateral thyroidectomy with both upper poles retained; group D, bilateral subtotal thyroidectomy with both lower poles retained.
There were no significant differences in each groups in terms of preoperative preparation methods, preoperative thyroid function, operating time. and amount of remained thyroid tissue.
@ES The results were follows:
@EN 1) Bleeding complication was noted in 25% in group A 5% in group D.
Temporary recurrent laryngeal nerve paralysis took place 9.1% in B group, 7% in C group, and 10% in D group. Hypoparathyroidism, although transient in most cases, occured in 16.7% in 17%, 50%, 61.5%, and 20% in Group A, B, C, and D respectively.
2) Recurrent hyperthyroidism developed during follow-up examination in 8.3
%, 4.5%, 7.3%, and 20% in group A, B, C, and D respectively.
16. 7% in A group, 4.5% in B group, 27.3% in C group, and 25% ilFD group needed thyroxine supplementation for TSH suppression and correction of hypothyroid state.
Euthyroid state was maintained in 91%, 75%, 55%, and 46.2% in group A, B, C, and D respectively.
The results suggest that hemithyroidectomy plus contralaterla resection may be a good alternative resection method for Graves' disease.
In conclusion, Graves' disease can be treated by diverse-typed surgical resection methods selected from the extent and shape of goiter and surgeon's experience.
|