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- Title
Graves' Disease with Moderate–Severe EndocrineOphthalmopathy–Long Term Results of a Prospective,Randomized Study of Total or Subtotal Thyroid Resection.
- Authors
J. Järhult; C. Rudberg; E. Larsson; H. Selvander; K. Sjövall; B. Winsa; J. Rastad; F.A. Karlsson
- Abstract
The optimal thyroid surgery to be performed in patients with Graves' disease and concomitant endocrine ophthalmopathyis a matter of debate. We randomly assigned 44 patients with moderate–severe eye signs in a trialof treatment with subtotal, leaving a small (approximately 2 g) thyroid remnant, or total thyroidectomy. At inclusion,the patients had been treated with antithyroid drugs, and corticosteroids been given to 12 (27%). Allreceived postoperative thyroxine supplementation and were followed for 3 years at regular examinations. Theeye disease improved in all cases, and throughout the study, the two groups did not differ with regard to subjectiveand objective eye symptoms and laboratory findings. At the study start, motility disturbances were presentin 8 and 11 of the cases in the subtotal and total resection group and proptosis in 16 and 17, respectively.After 3 years, the corresponding data were 3 and 6 cases with motility defects and 16 and 15 cases with proptosis.Thyrotropin (TSH)-receptor antibody levels gradually fell and became nondetectable in 21 (49%). The surgicalcomplication rate (permanent recurrent laryngeal nerve paresis and permanent hypoparathyroidism) wassignificantly higher in the total thyroidectomy group.The data indicate that in patients with Graves' diseaseand active endocrine ophthalmopathy, subtotal thyroidectomy, leaving a small thyroid remnant, will reducethe risk of surgical complications but not the beneficial effect of surgery.
- Publication
Thyroid, 2005, Vol 15, Issue 10, p1157
- ISSN
1050-7256
- Publication type
Article