di
A. Catania, E. Guaitoli, G. Carbotta, M. Bianchini, F.M. Di Matteo, S. Carbotta, M. Nardi, E. Fabiani, G. Grani, V. D’Andrea, A. Fumarola
Objectives. Graves’ disease (GD) is the most common cause of
hyperthyroidism, and accounts worldwide for 60-80% of all cases. The
diagnosis is based on clinical findings, and is confirmed by the presence
of TRAB, suppression of TSH, and elevation of free thyroxin (free
T4), and triiodinethyronin (free T3). GD can be treated by antithyroid
drugs, radioactive iodine, or surgery. The aim of this study was to
review retrospectively the surgical management, in terms of safety and
efficacy, in 50 patients operated in the Department of Surgical Sciences
since 2005 through 2010 and followed up at the Endocrinology Unit
A of the Experimental Medicine Department. We assessed postoperative
complications, which included the presence, persistence and
development of ophthalmopathy, transient hypocalcemia, permanent
hypoparathyroidism and recurrent laryngeal nerve palsy. Materials and Methods. We analyzed data from 50 patients with
GD who were eligible and underwent Total Thyroidectomy (TT).
Thirty-nine patients underwent TT for recurrent hyperthyroidism after
medical therapy and eleven patients for severe ophtalmopathy. The
mean follow up was 41 months (range: 10-70). Results. Eleven patients had ophtalmopathy before surgery. Four
patients developed an ophtalmopathy after surgery. Eleven patients
presented hypocalcemia, transient in ten patients and permanent in
one patient. Five patients developed a transient disphony. Conclusions. Total thyroidectomy is a safe and radical procedure
in Graves’ disease treatment. Complications of TT are not different
than subtotal thyroidectomy if it’s performed by expert surgeons. Clin
Ter 2013; 164(3):193-196. doi: 10.7417/CT.2013.1548
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