Endocrine Abstracts

Introduction: Graves’ disease is an immune system disorder that results in the overproduction of thyroid hormones. Treatment include: anti-thyroid medications, beta blockers, radioiodine therapy and surgery.

Objective: The aim of our study is to describe the role of surgery in the treatment of Graves’ disease.

Patients and methods: We conducted a retrospective study including 40 patients who underwent surgery for Graves’ disease in our department between 1996 and 2022.

Results: Our series included 30 women and 10 men, aged between 11 years and 63 years. All of the patients had hyperthyroidism. Thirty-eight patients had a goiter. A vascular thrill was perceived in 4 patients. Twelve patients had Graves’ orbitopathy. All of the patients were treated with anti-thyroid drugs and β blockers. The average duration of medical treatment was 18 months. No patient was treated with radioiodine therapy. 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), side effects of antithyroid drugs (2 cases) and pregnancy (1 case). All of the patients had a total thyroidectomy. Seven patients developed postoperative complications such as transient hypocalcemia (6 cases) and recurrent laryngeal nerve palsy (1 case). No case of recurrent disease was noted.

Conclusion: Antithyroid drugs are used as initial treatment in Graves’ disease. If remission is not achieved, radio-iodine therapy and surgery are considered as treatment options. Compared to surgery, radioiodine therapy can increase the risk of cancer and cause worsening of Graves’ opthalmopathy, especially in children. Therefore, surgery may be a better option.