ETA2023 Poster Presentations Graves’ Disease (9 abstracts)
Preoperative management of graves’ disease: should all patients be euthyroid?
Chisato Tomoda 1 , Reiko Ono 1 , Kana Yoshioka 1 , Yoshiyuki Saito 1 , Chie Masaki 2 , Junko Akaishi 2 , Kiyomi Hames Yamada 1 , Ritsuko Okamura 1 , Akifumi Suzuki 3 , Ken-ichi Matsuzu 1 , Wataru Kitagawa 4 , Kiminori Sugino 1 & Koichi Ito 3
1Ito Hospital, Surgery, Tokyo, Japan; 2Ito Hospital, Ito Hospital, Ito Hospital, Tokyo, Japan; 3Ito Hospital, Ito Hospital, Surgery, Tokyo, Japan; 4Ito Hospital, Ito-Hospital, Surgery, Tokyo, Japan
Context: Prior to thyroidectomy for Graves’ disease, thyroid function should be adequately controlled to avoid complications such as thyroid storm. However, preoperative thyroid function control is sometimes difficult.
Objective: This study assessed the postoperative risks are increased or not if biochemically hyperthyroid patients undergoing total thyroidectomy in comparison to euthyroid patients.
Methods: A retrospective, cohort study was conducted. A total of 1,884 patients undergoing total thyroidectomy for Graves’ disease from January 2010 to December 2020 were evaluated. Preoperative thyroid function, vital sign (heart rate and body temperature), thyroid storm, hypocalcemia, paralysis of the vocal cord, and postoperative bleeding were evaluated.
Results: The patients’ mean age was 38 years, and 1,394 patients (75.6%) were female. A total of 1,644 patients (89.1%) were treated with anti-thyroid drugs, 213 patients (11.5%) with beta-blockers, 396 patients (21.5%) with potassium iodide, and 92 (4.9%) with glucocorticoids. At the time of surgery, 64.9% remained hyperthyroid as defined by the TSH level. On the other hand, serum free T4 and free T3 were in the normal range in 55.9% and 76.9% of cases, respectively. There was a significant difference in postoperative heart rate and the rate of transient hypocalcemia between the patients with a higher free T3 level more than normal range and those with normal free T3 level, but not in the other postoperative complications. No patient developed thyroid storm.
Conclusion: Preoperative thyroid function control was based mainly on control of serum free T3 levels in exceptional circumstances. Of the patients who were biochemical hyperthyroid status at the time of surgery, none developed sever complication.
Volume 92
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Endocrine Abstracts
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