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

Publication

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

Journal Paper/Review - Oct 1, 2017

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

Citation

Vital D, Morand G, Meerwein C, Laske R, Steinert H, Schmid C, Brown M, Huber G. Early Timing of Thyroidectomy for Hyperthyroidism in Graves' Disease Improves Biochemical Recovery. World J Surg 2017; 41:2545-2550.

Type

Journal Paper/Review (English)

Journal

World J Surg 2017; 41

Publication Date

Oct 1, 2017

Issn Electronic

1432-2323

Pages

2545-2550

Brief description/objective

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.