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World Journal of Surgery
Published in: World Journal of Surgery 10/2017

01-10-2017 | Original Scientific Report

Early Timing of Thyroidectomy for Hyperthyroidism in Graves’ Disease Improves Biochemical Recovery

Authors: Domenic Vital, Grégoire B. Morand, Christian Meerwein, Roman D. Laske, Hans C. Steinert, Christoph Schmid, Michelle L. Brown, Gerhard F. Huber

Published in: World Journal of Surgery | Issue 10/2017

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Abstract

Background

The role of thyroidectomy as an early treatment for hyperthyroidism has been poorly investigated. Our aim was to examine its success rates, particularly focusing on thyroidectomy as an early treatment.

Methods

Patients with thyroidectomy for hyperthyroidism between February 2008 and October 2014 were included. They were divided into two groups (early and delayed thyroidectomy), and patient characteristics, treatment indications, complications and time to biochemical recovery were analyzed.

Results

Ninety-nine patients met the inclusion criteria, of whom 65 (66%) suffered from Graves’ disease, 25 (25%) from toxic goiters and 9 (9%) from amiodarone-induced hyperthyroidism. Structural abnormalities of the thyroid (39 patients, 39%) represented the most frequent indications for thyroidectomy. Forty-six patients (46%) underwent an early and 53 (54%) a delayed surgical approach. Patients with Graves’ disease undergoing early thyroidectomy did not suffer more often from complications but had a significantly faster biochemical recovery after surgery than those with a delayed thyroidectomy, as judged by a shorter time to reach TSH (121 ± 24 vs. 240 ± 31 days, p = 0.007) and fT4 (91 ± 29 vs. 183 ± 31 days p = 0.015) levels in the normal range. As expected, there were no recurrences of hyperthyroidism.

Conclusions

Early thyroidectomy was neither associated with permanent complications nor thyroid storm, but with a significantly improved biochemical recovery and therefore has to be recommended early in patients with Graves’ disease.
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Metadata
Title
Early Timing of Thyroidectomy for Hyperthyroidism in Graves’ Disease Improves Biochemical Recovery
Authors
Domenic Vital
Grégoire B. Morand
Christian Meerwein
Roman D. Laske
Hans C. Steinert
Christoph Schmid
Michelle L. Brown
Gerhard F. Huber
Publication date
01-10-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 10/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4052-1

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