Endocrine Abstracts

Introduction: Graves’ disease is an autoimmune disease of the thyroid gland, which represents the most common cause of hyperthyroidism, accounting for 50 - 80% of all cases. Three treatment options are available for Graves’ disease: anti-thyroid drugs, radioactive iodine and thyroidectomy. But therapeutic management is still controversial. The aim of our study is to discuss, after a review of the literature, the role of surgery in the treatment of Graves’ disease.

Patients and methods: We conducted a retrospective study of medical records of 40 patients who underwent surgery for Graves’ disease in our department between 1996 and 2019.

Results: Our series included 30 women and 10 men, aged between 11 years and 63 years. All our patients had hyperthyroidism. Thirty-eight patients had a diffuse goiter whereas the gland was not palpable in 2 patients. A vascular thrill was perceived in 4 patients. Twelve patients had Graves’ orbitopathy. All our patients were treated with anti-thyroid drugs and β blockers. The average duration of medical treatment was 18 months. No patient in our series was treated with radioactive iodine. Indications for surgery were: failed medical therapy after 2 years of treatment (29 cases), a compressive goiter (4 cases), concomitant suspicious thyroid nodules (4 cases), second effect of antithyroid drugs (2 cases) and pregnancy (1 case). All our patients had a total thyroidectomy. Seven patients developed post operative complications: transient hypocalcemia in six cases and recurrent laryngeal nerve palsy in one case. No case of recurrent disease was noted.

Conclusion: Total thyroidectomy is the more efficient radical method for treating patients with Graves’ disease. It offers rapid and durable control of hyperthyroidism.