Endocrine Abstracts

Introductions: Some surgeons are easy to avoid total thyroidectomy as a surgical treatment for Graves’disease and even for thyroid cancer, because of possible complications (i.e. laryngeal nerve injury, hypoparathyroidism, etc). We studied the benefits and complications of total thyroidectomy in 206 patients with Graves’ disease or with thyroid cancer who were treated in our institution.

Methods: Surgical outcomes were analysed in the following two groups. 101 patients with Graves’ disease (group A) and 105 patients with thyroid cancer (group B) underwent total thyroidectomy in the past three years. We evaluated post-operative hypocalcemia, laryngeal nerve injury, and pathological findings in the both group and transition of TSH receptor antibody for group A.

Results: Post-operative hypocalcemias were recognized in 45 patients (44.6%) in group A and 38 patients (36.2%) in group B. Post-operative hypocalcemia appeared early in the patients with hungry bone. All of them except one recovered after taking some alfacacidol and calcium lactate for a couple of weeks. One patient in group B turned out permanent hypoparathyroidism. No laryngeal nerve injury was recognized. TSH receptor antibody was successfully decreased in almost all patients of group A. Incidentalomas (papillary carcinomas) were recognized in 5 patients (5.0%) of group A. Contra-lateral metastases were recognized in 7 patients (6.7%) of group B.

Conclusions: 5 patients with Incidentaloma and 7 patients with contra-lateral metastases were received benefit from the total thyroidectomy. Although 83 patients (40.3%) were suffered from post-operative hypocalcemia, 82 patients (98.8%) recovered within a short term. All patients successfully underwent the surgery and most of them felt happy being free from their diseases. Ultimately, to avoid relapse or recurrence of their diseases, total thyroidectomy is acceptable surgery even though they have to take thyroid hormone for the rest of their life.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector