KMID : 0361020110540110771
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Korean Journal of Otolaryngology - Head and Neck Surgery 2011 Volume.54 No. 11 p.771 ~ p.777
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Appropriate Surgical Extent in the Surgery for Graves¡¯ Disease
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Yoo Han-Seok
Kim Ki-Yong Ji Seon-Yeong Tae Kyung Kim Dong-Sun Ahn You-Hern
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Abstract
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Background and Objectives : Thyroidectomy for Graves¡¯ disease is a rapid, safe, highly successful treatment modality. Also thyroidectomy allows pathological examination for diagnosis of suspected cancer. However, the extent of thyroidectomy in Graves¡¯ disease is still controversial. The aim of this study is to evaluate the appropriate surgical extent by comparing the postoperative outcomes of two groups of patients with Graves¡¯ disease who underwent total or less than total thyroidectomy.
Subjects and Method : We carried out a retrospective review of 33 patients who underwent thyroidectomy for Graves¡¯ disease from January 2001 to December 2010. We investigated the postoperative thyroid hormone function and complication rate according to the extent of thyroidectomy.
Results: Among the 33 patients with Graves¡¯ disease, 19 patients underwent total thyroidectomy, six patients bilateral subtotal thyroidectomy (BST) and eight patients lobectomy and contralateral subtotal lobectomy (LCSL). Postoperative hypothyroidism, euthyroidism, and hyperthyroidism occurred in 27 (81.7%), 2 (6.1%) and 4 (12.2%) patients, respectively. Postoperative recurrent hyperthyroidism was observed in 2 (33.3%) patients of BST and in 2 (25.0%) of LCSL. One patient was found with permanent hypoparathyroidism, and two with transient vocal cord paralysis. According to histopathologic report, nine patients were accompanied with thyroid cancer.
Conclusion: Thyroidectomy for Graves¡¯ disease has high success rate, low recurrence rate and low complication rate. In terms of surgical extent, total thyroidectomy is a more appropriate procedure because of its low recurrence of hyperthyroidism.
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KEYWORD
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Graves¡¯ disease, Thyroidectomy, Hyperthyroidism
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