Advertisement

Journal of Endocrinological Investigation

, Volume 11, Issue 5, pp 371–374 | Cite as

Long term thyroid function after subtotal thyroidectomy for Graves’ disease

  • Benedetto Busnardo
  • M. E. Girelli
  • D. Rubello
  • C. Eccher
  • C. Betterle
Article

Abstract

Between 1973 and 1980,93 patients with Graves’ disease underwent subtotal thyroidectomy by the same surgeon (the size of thyroid remnant was 4 g per side). No case of operative mortality, no case of thyroid storm nor of surgical complications occurred. Three months after surgery 40% of patients were euthyroid, 25% had overt hypothyroidism, 35% had subclinical hypothyroidism. In the following yr important variations of thyroid function were observed. The number of patients with subclinical hypothyroidism decreased slowly (22% and 9% at 3 and 6 yr, respectively), and some became euthyroid, some hypothyroid, others relapsed. Seven patients had recurrent hyperthyroidism. In particular at 3 yr 45% of patients wereeuthyroid, 28% had overt hypothyroidism, 22% had subclinical hypothyroidism, 4% had recurrence; at 6 yr 56% were euthyroid, 32% had overt hypothyroidism, 9% had subclinical hypothyroidism, 3% had recurrence. Four out of the 8 patients operated under 20-yr-old became hypothyroid in comparison with only 2 out of the 15 patients over 50-yr-old. Relapses were present only in patients operated at less than 40-yr and only in females. No correlation was found between thyroid lymphocytic infiltration and thyroid function after surgery, nor between the presence of antithyroid antibodies and hypothyroidism. AH cases who relapsed had high TMA titers both before and after operation. this study confirms the need for accurate follow-up after subtotal thyroidectomy for Graves’ disease.

En]Keywords

Graves’ disease thyroid function thyroidectomy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Klioua R., Momex R., Berthezene F., Fitoussi R. Traitment chirurgical de la maladié de Basedow. Annales d’Endocrinologie 41: 614, 1980.PubMedGoogle Scholar
  2. 2.
    Blondeau P., Wolfeier L., Rene L. Traitment chirurgical de la maladià de Basedow. A propos d’une expérience de 823 interventions. Ann. Chir. 32: 779, 1978.Google Scholar
  3. 3.
    Liechty R.D., Silverberger S.G., Hernandez J. Limited subtotal thyroidectomy for Graves’ disease. Arch. Surg. 116: 651, 1981.CrossRefGoogle Scholar
  4. 4.
    Lundstrom B., Gillquist J. The importance of elevated TSH in serum after subtotal thyroidectomy for hyperthyroidism. Acta Chir. Scand. 147: 645, 1981.PubMedGoogle Scholar
  5. 5.
    Tweedle D., Colling A., Schardt W., Green E.M., Evered D.C., Dickinson P.H., Johnson I.D.A. Hypothyroidism following partial thyroidectomy for thyrotoxicosis and its relationship to thyroid remnant size. Br.J. Surg. 64: 445, 1977.PubMedCrossRefGoogle Scholar
  6. 6.
    Noguchi S., Murakami N., Noguchi A. Surgical treatment for Graves’ disease: a long term follow-up of 325 patients. Br. J.Surg. 68: 105, 1981.PubMedCrossRefGoogle Scholar
  7. 7.
    Toft M.B., Jorgensen S.J., Hansen J.B., Boolsen S.W. Ibsen J. Long-term observation of thyroid function after surgical treatment of thyrotoxicosis. Acta Chir. Scand. 143: 221, 1977.Google Scholar
  8. 8.
    Michie W., Beck J.S., Pollet J.E. Prevention and management of hypothyroidism after thyroidectomy for thyrotoxicosis. World J.Surg. 2: 307,. 1978.PubMedCrossRefGoogle Scholar
  9. 9.
    Farneil M.B., Van Heerden J.A., McConahey W.M., Carpenter H.A., Wolff L.H. Hypothyroidism after thyroidectomy for Graves’ disease. Am.J. Surg. 142: 535, 1981.CrossRefGoogle Scholar
  10. 10.
    Steel N.R., Taylor J.J., Young E.T., Farndon J.R., Holcombe M., Taylor P.K. The effect of subtotal thyroidectomy with propanolol preparation on antibody activity in Graves’ disease. Clin. Endocrinol. 26: 97, 1987.CrossRefGoogle Scholar
  11. 11.
    Yamada T., Tsukui T., Ikejiri K., Kotani M. Volume of sella turcica in normal subjects and in patients with primary hypothyroidism and hyperthyroidism. J. Clin. Endocrinol. Metab. 42: 817, 1976.PubMedCrossRefGoogle Scholar
  12. 12.
    Weetman A.P., McGregor A.M., Wheeler M.H., Hall R. Extrathyroid sites of autoantibody synthesis in Graves’ disease. Clin: Exp. Immunol. 56: 330, 1984.Google Scholar
  13. 13.
    Hamburger J.I. Management of hyperthyroidism in children and adolescents. J. Clin. Endocrinol. Metab. 60: 1019, 1985.PubMedCrossRefGoogle Scholar
  14. 14.
    Olson W.R., Nishijama R.H., Graber L.W. Thyroidectomy for hyperthyroidism. Arch. Surg. 101: 175, 1970.CrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 1988

Authors and Affiliations

  • Benedetto Busnardo
    • 1
  • M. E. Girelli
    • 1
  • D. Rubello
    • 1
  • C. Eccher
    • 2
  • C. Betterle
    • 1
  1. 1.Istituto di Semeiotica MedicaUniversità di PadovaPadovaItaly
  2. 2.Divisione di ChirurgiaOspedale Civile di PadovaPadovaItaly

Personalised recommendations