[Results of surgery in graves disease]

ABSTRACT

The purpose of our study was to analyze the results of surgery in Graves disease, to determine the incidence of post operative complications and to discuss its status as a radical option comparatively to radioiodine therapy. This retrospective study included 100 patients who underwent surgical treatment of medical treatment after failure of anti thyroid therapy. Two sorts of thyroidectomy were performed subtotal thyroidectomy [STT] in 65% of the cases and total thyroidectomy [TT] in 35%. Post operative complications were frequent with 9% of paralysis of the recurrent nerve. Hypocalcemic episodes occured in 23% of our patients, hypocalcemia being transcient in 9% and permanent in 14% after a first surgery and 16% after reintervention. During the first year post operative hypothyroidism was present in 58% of our cases after STT. The relapse rate during the first six month was 25% [35% after STT and 5% after TT]. Finally papillary microcarcinoma foci were found in one case [1%]. In conclusion, thyroid surgery exposes to a high morbidity [hypoparathyroidism and palsy of the recurrent nerve] and a high relapse rate. This radical option should be compared to the radioiodine therapy in order to give the patient the best therapeutic option