Surgery for Graves鈥?disease: a 25-year perspective

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• 作者：Roy Phitayakorn ; Dieter Morales-Garcia ; Jonathan W ; erer ; Carrie C. Lubitz ; R ; all D. Gaz ; Antonia E. Stephen ; Jesse M. Ehrenfeld ; Gilbert H. Daniels ; Richard A. Hodin ; Sareh Parangi
• 关键词：Graves&rsquo ; disease ; Surgical therapy ; Incidental malignancy
• 刊名：The American Journal of Surgery
• 出版年：November, 2013
• 年：2013
• 卷：206
• 期：5
• 页码：669-673
• 全文大小：129 K

文摘

Background

Optimal treatment of Graves鈥?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.