Comparison Between Total And Subtotal Thyroidectomy In Graves’ Disease
Total And Subtotal Thyroidectomy In Graves’ Disease
DOI:
https://doi.org/10.70284/njirm.v4i1.2123Keywords:
Graves’ Disease, Subtotal Thyroidectomy, Total ThyroidectomyAbstract
Objective: To compare the results of total thyroidectomy and subtotal thyroidectomy amongst the surgically treated patients with Graves’ Disease. Material and Method: This study includes 50 patients of Graves’ disease out of which 27 patients underwent for total thyroidectomy and 23 underwent for subtotal thyroidectomy. Comparison done in regards to postoperative complication between total and subtotal thyroidectomy in terms of advantages and disadvantages. Results: Incidence of transient or permanent recurrent laryngeal nerve palsy and hypocalcemia were high amongst the patients operated for total than subtotal thyroidectomy. Thyroid function tests were normal in all patients after total thyroidectomy with hormone replacement therapy and 17.39% of patients had hypothyroidism after subtotal thyroidectomy. Recurrence rate was nil and 21.73% respectively in total and subtotal thyroidectomy. One patient of subtotal thyroidectomy had occult carcinoma in histopatholical examination which required revision of surgery. Conclusion: Total thyroidectomy is superior to subtotal thyroidectomy based on the considerable surgical risk and lack of recurrence in total thyroidectomy as well as the risk of occult carcinoma and questionable ability of the subtotal thyroidectomy to maintain the euthyoid state.
References
2. Hanks JB-Thyroid. In: Townsend, Beauchamp, Evers, Mattox -Sabiston Textbook of Surgery.Vol1.17thedition.Philadelphia,USA; Elsevier ,2004: 947-984.
3. Krukowski ZH-The thyroid gland and the thyroglossal tract In :Russell RCG, Williams NS, Bulstrode CJK- Bailey and Love’s short practice of surgery.24thedition.London:Hodder education,2004: 776-804.
4. Boger MS, Perrien ND. Graves’ and Plummer’s disease: Medical and Surgical Management In: Clark OH, Duh QY, Kebebew E-Textbook of Endocrine surgery. 2nd edition. Philadelphia USA; .Elsevier publication,2005: 54-67.
5. Sadler GP, Dudley N. The thyroid gland In :Morris PJ,Wood WC-Oxford Textbook of Surgery.Vol 1. 2nd edition.New York:Oxford University Press,2000: 1096-1120.
6. Nicolosi A, Meleddu C, Meleddu G, Massidda B, Calo PG, Pinna M, Tarquini A-Current trends in the treatment of Graves’ disease. Minerva Chir 1995; 50(7-8): 659-665. PMID : 8532200.
7. Clech GL, Case A, Mohr E, Bouilloud F, Commessie JF-Surgery for Graves’ disease, A review of 378 cases.Fr ORL 2005;86: 10-15.
8. Ku CF, Lo CY, Chan WF, Kung AWC and Lam KSL-Total Thyroidectomy replaces Subtotal Thyroidectomy as the preferred surgicaltreatment for Graves’ disease. ANZ J. Surg.2005;75 : 528-531.
9. Palit TK, Miller CC 3rd, Miltenburg DM-The efficacy of thyroidectomy for Graves’disease: A meta-analysis, PMID : 10792958.
10. Barczynski M, Konturek A, Hubalewska-Dydejczyk A, Golkowski F, Nowak W-Randomized clinical trial of bilateral subtotal thyroidectomy versus total thyroidectomy for Graves’ disease with a 5 – year follow up. Br J Surg 2012;99(4):515-522. PMID : 22287122.
11. Witte J, Goretzki PE, Dotzenrath C, Simon D, Felis P, Neubauer M, and Roher HD- Surgery for Graves’ disease: total versus subtotal thyroidectomy – results of a prospective randomized trial. World journal of surgery 2000;24(11):1303-1311.PMID : 11038198.
12. Koulas SG, Zikos N, Tsimoyiannis JC, Tsirves G, Tsimoyiannis EC-Incidence of Thyroid Occult Carcinoma in patients with Graves’ disease. The Internet Journal of Surgery 2008;17(1). http://www.ispub.com:80/journal/the-internet-journal-of-surgery/volume-17-number-1/incidence-of-thyroid-occult-carcinoma-in-patients-with-graves-disease.html.
13. Kotan C, Kosem M, Algun E, Aykta H, Sonmez R, Soylemez O-Influence of the Refinement of Surgical Technique and surgeon’s experience on the rate of complications after total thyroidectomy for Benign Thyroid Disease. Acta chir belg, 2003;103: 278-281