Naseem Baloch, Maryam Noor.
Role of surgery in management of Graves’ Disease (GD): An eleven year experience.
Pak J Surg Jan ;30(2):110-4.

Background: Th yroidectomy as the fi rst line treatment for Graves’ Disease (GD) is still controversial in view of presumed increased incidence of complications. Th e purpose of this study is to analyze the safety and effi cacy of thyroid surgery among patients with GD based on our experience, highlighting the morbidity and satisfactory outcomes in experienced hands. Methods: Ninety-six patients with GD underwent thyroid surgery between February 2002 to January 2013 at Endocrine Surgical unit, ward 2. JPMC. Preoperative, intra-operative and post-operative variables were analyzed. Results: A total of 2300 patients underwent thyroid surgery, of these 96 were for Graves’ disease. 62.5% (n=60) Near total thyroidectomy (NTT ), 37.5% (n=36) subtotal thyroidectomy (STT ) were performed. Reasons for having thyroid surgery were persistent disease due to failure of Medical therapy (46.6%), patient preference (24.1%), Multiple/solitary Nodules (20.3%), failed RA I treatment (16%), ophthalmopathy (12.1%) and referrals (4.6%). Transient symptomatic Hypocalcemia occurred in 3.12% (n=3) of patients, one patient had symptomatic hypocalcemia lasting upto 6 months. Th ere were no permanent Recurrent Laryngeal Nerve injuries. Th ere was no diff erence between overall complication rates between patients based on surgical procedure (NTT vs. STT ). However, Recurrences occurred in 5.55% (n=2) of the STT group and 0% in the NTT group. Conclusion: Th yroidectomy for patients with Graves’ disease can be performed with very low complication rates and when a Near total thyroidectomy is performed there is almost no risk of recurrence.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com