J.Jpn. Surg. Soc.. 94(9): 1043-1046, 1993
Original article
UNFAVORABLE CHARACTERISTICS IN PATIENTS WITH EARLY POSTOPERATIVE RECURRENCE OF GRAVES' DISEASE AFTER SUBTOTAL THYROIDECTOMY
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Department of Endocrine Surgery, Tokyo Women's Medical College, Tokyo, Japan Takahiro Okamoto, Yoshihide Fujimoto, Takao Obara, Yukio Ito, Masatoshi Iihara, Yoshiharu Kanaji, Tomoyuki Yamashita |
We examined 338 patients who underwent subtotal thyroidectomy during a 9-year period from 1981 to 1989. Thyroid functional status was determined biochemically and the following variables were collected and divided into two categories for each patient: sex, age at operation, indication for surgery, serum titer of antimicrosomal hemagglutination antibody, weight of resected thyroid tissue and size of remnant thyroid tissue relative to body surface area. Early postoperative recurrence was defined as relapse of the disease within one year after surgery, necessitating medication or radioiodine therapy.
Logistic regression analysis disclosed that the most important characteristics were age＜20 yr, relatively large thyroid remnant and weight of resected thyroid tissue 2≥ 100g, the odds ratios for these variables being 20.6, 16.7 and 3.4, respectively (p＜0.05).
Although candidates for surgical treatment of Graves' disease are likely to be younger and to have a large goiter, these characteristics are unfavorable, since they predict the early recurrence of hyperthyroidism. One alternative is to leave a smaller than usual thyroid remnant thyroid in these patients, even if the risk of postoperative hypothyroidism is high.
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