Thyroid function after subtotal thyroidectomy in patients with Graves' hyperthyroidism

ScientificWorldJournal. 2012:2012:548796. doi: 10.1100/2012/548796. Epub 2012 Feb 1.

Abstract

Background: Subtotal thyroidectomy is a surgical procedure, in which the surgeon leaves a small thyroid remnant in situ to preserve thyroid function, thereby preventing lifelong thyroid hormone supplementation therapy.

Aim: To evaluate thyroid function after subtotal thyroidectomy for Graves' hyperthyroidism.

Subjects and methods: We retrospectively reviewed the medical records of all patients (n = 62) who underwent subtotal thyroidectomy for recurrent Graves' hyperthyroidism between 1992 and 2008 in our hospital. Thyroid function was defined according to plasma TSH and free T4 values.

Results: Median followup after operation was 54.6 months (range 2.1-204.2 months). Only 6% of patients were euthyroid after surgery. The majority of patients (84%) became hypothyroid, whereas 10% of patients had persistent or recurrent hyperthyroidism. Permanent recurrent laryngeal nerve palsy and permanent hypocalcaemia were noted in 1.6% and 3.2% of patients, respectively.

Conclusion: In our series, subtotal thyroidectomy for Graves' hyperthyroidism was associated with a high risk of postoperative hypothyroidism and a smaller, but significant, risk of persistent hyperthyroidism. Our data suggest that subtotal thyroidectomy seems to provide very little advantage over total thyroidectomy in terms of postoperative thyroid function.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Graves Disease / physiopathology
  • Graves Disease / surgery*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thyroid Function Tests*
  • Thyroidectomy*
  • Young Adult