A Comparative Study between Total and Subtotal Thyroidectomy for the Management of Graves' Disease

Abstract

Background: Graves' disease is an autoimmune disease that causes the thyroid to overproduce and over-secrete thyroid hormones. This results in hyperthyroidism and can cause a wide variety of symptoms to occur. Aim of the work: This study is conducted to compare total vs subtotal thyroidectomy in the management of Graves' disease as regards control of the disease, incidence of recurrence and postoperative complications. Patients and Methods: This is a prospective study which included 40 patients with primary thyrotoxicosis (Graves' disease) and was conducted in Ain Shams University Hospitals and Dar El Shefa Hospital. The Graves 'disease was diagnosed on the basis of clinical symptoms and signs, serum level of thyroid hormones and thyroid stimulating hormones, neck ultrasound and thyroid scan. Results: The present study showed statistically insignificant difference between both groups as regard need for Eltroxin by using Fisher exact test. No significant difference as regards other variables. Relapse occurred in 2 cases of subtotal group and these 2 patients needed radio active iodine ablation. Conclusion: This study confirmed that total thyroidectomy is being increasingly adopted for patients requiring surgical treatment for Graves’ disease, based on a comparable surgical risk and the lack of recurrence, as well as the questionable ability of subtotal thyroidectomy to maintain euthyroidism. Recommendations: Further studies on large scale of patients are needed to confirm these results. Key words: Grave’s disease, autoimmune disease, thyroid, total thyroidectomy, euthyroidism