Surgery for Graves' disease: a 25-year perspective

Am J Surg. 2013 Nov;206(5):669-73. doi: 10.1016/j.amjsurg.2013.07.005. Epub 2013 Sep 4.

Abstract

Background: Optimal treatment of Graves' disease (GD) remains controversial. The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center.

Methods: Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy over 25 years, in 3 periods: 1985 to 1993 (n = 32), 1994 to 2002 (n = 91), and 2003 to 2010 (n = 177).

Results: There were 300 patients with GD (85.7% women; mean age, 39.3 years; median length of follow-up, 24.6 months). Overall, perioperative morbidity occurred in 36 patients (12.0%), and there was no mortality. Thyroidectomy-specific morbidity was very low, and the incidental malignancy rate was 10.3%.

Conclusions: Surgical treatment of GD has a very high safety profile, with low perioperative and thyroidectomy-specific morbidity, even in patients with overt hyperthyroidism. Incidental malignancy in patients with GD is not uncommon.

Keywords: Graves’ disease; Incidental malignancy; Surgical therapy.

MeSH terms

  • Ablation Techniques / trends
  • Adult
  • Antithyroid Agents / therapeutic use
  • Drainage / trends
  • Female
  • Graves Disease / surgery*
  • Humans
  • Incidental Findings
  • Iodine Radioisotopes / therapeutic use
  • Length of Stay / trends
  • Male
  • Massachusetts
  • Methimazole / therapeutic use
  • Operative Time
  • Postoperative Complications
  • Preoperative Care
  • Propylthiouracil / therapeutic use
  • Retrospective Studies
  • Thyroid Neoplasms / epidemiology
  • Thyroidectomy* / trends

Substances

  • Antithyroid Agents
  • Iodine Radioisotopes
  • Methimazole
  • Propylthiouracil