Surgical treatment of Graves disease
Vergilius José Furtado de Araújo Filho, Erivelto Martinho Volpi, Flávio Carneiro Hojaij, Wellington Alves Filho, Arthur Vicentini da Costa Luiz, Claudio Roberto Cernea, Lenine Garcia Brandão
Abstract
Introduction: There is no proved superiority between surgical and non-surgical treatment for Graves’ disease up to now. Objective: To evaluate our surgical experience in the treatment of Graves’ disease. Materials and Methods: A total of 96 patients with Graves’ disease underwent thyroidectomy from 2002 to 2012. All patients were operated on under euthyroid condition, achieved by the use of antithyroid drugs associated to beta‑blockers. Follow-up period ranged from 1 to 10 years. Results: All patients developed hypothyroidism. There was no recurrence. The main complications observed were transient hypoparathyroidism in 23 cases (24%), transient hoarseness in 7 patients (7%), hematoma in the immediate post-operative period in 2 cases (2%) and permanent hypoparathyroidism in 1 patient (1%). No death was observed in this series. The time of hospitalization varied from 1 to 5 days and 78% of the patients were discharged in the first postoperative day. Conclusion: Thyroidectomy is effective and safe, with low complication rates.
Keywords
References
1. Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, Laurberg P, McDougall IR, Montori VM, Rivkees SA, Ross DS, Sosa JA, Stan MN. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011(21):593-646. http://dx.doi.org/10.1089/thy.2010.0417.
2. Bartalena L. Diagnosis and management of Graves disease: a global overview. Nat Rev Endocrinol. 2013;9(12):724-34. http://dx.doi.org/10.1038/nrendo.2013.193. PMid:24126481.
3. Solomon B, Glinoer D, Lagasse R, Wartofsky L. Current trends in the management of Graves’ disease. J Clin Endocrinol Metab. 1990;70(6):1518-24. http://dx.doi.org/10.1210/jcem-70-6-1518. PMid:1693371.
4. Palmeiro C, Davila MI, Bhat M, Frishman WH, Weiss IA. Subclinical hyperthyroidism and cardiovascular risk: recommendations for treatment. Cardiol Rev. 2013;21(6):300-8. http://dx.doi.org/10.1097/CRD.0b013e318294f6f1. PMid:23563523.
5. Burch HB, Burman KD, Cooper DSA. 2011 survey of clinical practice patterns in the management of Graves’ disease. J Clin Endocrinol Metab. 2012;97(12):4549-58. http://dx.doi.org/10.1210/jc.2012-2802. PMid:23043191.
6. Feliciano DV, Lyons JD. Thyroidectomy is optimal treatment for Graves’ disease. J Am Coll Surg. 2011;212(4):714-20, discussion 720-1. http://dx.doi.org/10.1016/j.jamcollsurg.2010.12.036. PMid:21463819.
7. Phitayakorn R, Morales-Garcia D, Wanderer J, Lubitz CC, Gaz RD, Stephen AE, Ehrenfeld JM, Daniels GH, Hodin RA, Parangi S. Surgery for Graves’ disease: a 25-year perspective. Am J Surg. 2013;206(5):669-73. http://dx.doi.org/10.1016/j.amjsurg.2013.07.005. PMid:24011567.
8. Genovese BM, Noureldine SI, Gleeson EM, Tufano RP, Kandil E. What is the best definitive treatment for Graves’ disease? A systematic review of the existing literature. Ann Surg Oncol. 2013;20(2):660-7. http://dx.doi.org/10.1245/s10434-012-2606-x. PMid:22956065.
9. Scerrino G, Morfino G, Paladino NC, Di Paola V, Amodio E, Gulotta G, Bonventre S. Does thyroid surgery for Graves’ disease improve health-related quality of life? Surg Today. 2013;43(12):1398-405. http://dx.doi.org/10.1007/s00595-012-0442-z. PMid:23229839.
10. Palit TK, Miller CC 3rd, Miltenburg DM. The efficacy of thyroidectomy for Graves’ disease: a meta-analysis. J Surg Res. 2000;90(2):161-5. http://dx.doi.org/10.1006/jsre.2000.5875. PMid:10792958.
11. Sugino K, Ito K, Nagahama M, Kitagawa W, Shibuya H, Ohkuwa K, Yano Y, Uruno T, Akaishi J, Suzuki A, Masaki C, Ito K. Changes in the thyroid function of Graves’ disease patients treated by subtotal thyroidectomy. Endocr J. 2012;59(12):1115-
20. http://dx.doi.org/10.1507/endocrj.EJ12-0260. PMid:22971989.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email