2000, Number 4
Cir Gen 2000; 22 (4)
Sánchez BJ, Lamata HF, García GFA, Martínez DM, González GM
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ABSTRACTObjective: To determine the best surgical technique to treat hyperthyroidism due to Graves’s disease
Design: Prospective, longitudinal and comparative study
Setting: University Hospital
Patients and methods: Between 1969 and 1991, 108 patients underwent surgery to treat Basedow’s disease in our service. The choice of technique was randomised since the objective was to determine which modality (total or subtotal thyroidectomy) produced better results with a lower morbidity rate
Statistical analysis: Chi square (χ2) and Student,s t test
Results: Fifty subtotal and 53 total thyroidectomies were performed. The degree of hypoparathyroidism was greater following total thyroidectomy as compared to the subtotal intervention. No differences were observed between the two in regard to the rate of recurrent laryngeal nerve lesion. Subtotal thyroidectomy is associated to a low incidence of diffuse recurrence of hyperthyroidism, absence of nodular recurrences, improvement in exophthalmos and cardio-thyrotoxicosis and a significantly lower rate of hypoparathyroidism compared with total thyroidectomy. Furthermore, it allows maintenance of 71% of euthyroid patients without opotherapy after a mean follow-up of 7.5 years.
Conclusion: Subtotal thyroidectomy is the technique of choice for surgical treatment of Graves’ disease