Graves' disease surgery: Difference between revisions
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{{CMG}},{{AE}}{{MehdiP}} | {{CMG}},{{AE}}{{MehdiP}} | ||
==Overview== | ==Overview== | ||
Thyroidectomy is recommended for some patients including, patients with large goiters, women wishing to become pregnant shortly after treatment, patients who want to avoid exposure to antithyroid drugs or radioiodine. | |||
== Surgery == | == Surgery == | ||
*The patients' thyroid hormone must be normalized before surgery to minimize the risk of surgery. | *The patients' thyroid hormone must be normalized before surgery to minimize the risk of surgery. | ||
*Treatment with inorganic iodide commencing 1 week before surgery may decrease thyroid blood flow, vascularity, and blood loss but does not otherwise influence surgical risk. | *Treatment with inorganic iodide commencing 1 week before surgery may decrease thyroid blood flow, vascularity, and blood loss but does not otherwise influence surgical risk.<ref name="pmid17389702">{{cite journal |vauthors=Erbil Y, Ozluk Y, Giriş M, Salmaslioglu A, Issever H, Barbaros U, Kapran Y, Ozarmağan S, Tezelman S |title=Effect of lugol solution on thyroid gland blood flow and microvessel density in the patients with Graves' disease |journal=J. Clin. Endocrinol. Metab. |volume=92 |issue=6 |pages=2182–9 |year=2007 |pmid=17389702 |doi=10.1210/jc.2007-0229 |url=}}</ref> | ||
*Surgery is recommended for | *Surgery is recommended for:<ref name="pmid21700562">{{cite journal |vauthors=Bahn RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, Laurberg P, McDougall IR, Montori VM, Rivkees SA, Ross DS, Sosa JA, Stan MN |title=Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists |journal=Endocr Pract |volume=17 |issue=3 |pages=456–520 |year=2011 |pmid=21700562 |doi= |url=}}</ref> | ||
#Patients with large goiters | #Patients with large goiters | ||
#Women wishing to become pregnant shortly after treatment | #Women wishing to become pregnant shortly after treatment | ||
#Patients who want to avoid exposure to antithyroid drugs or radioiodine. | #Patients who want to avoid exposure to antithyroid drugs or radioiodine. | ||
*The course of | *The course of ophthalmopathy is not affected by thyroidectomy. | ||
{| class="wikitable" | {| class="wikitable" | ||
! | ! | ||
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* Most expensive therapy | * Most expensive therapy | ||
* Surgery and anesthesiology associated risks | * Surgery and anesthesiology associated risks | ||
* Major complications in 1-4% (hypoparathyroidism, recurrent laryngeal nerve | * Major complications in 1-4% (hypoparathyroidism, recurrent laryngeal nerve damage) | ||
|} | |} | ||
Latest revision as of 19:22, 5 April 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Thyroidectomy is recommended for some patients including, patients with large goiters, women wishing to become pregnant shortly after treatment, patients who want to avoid exposure to antithyroid drugs or radioiodine.
Surgery
- The patients' thyroid hormone must be normalized before surgery to minimize the risk of surgery.
- Treatment with inorganic iodide commencing 1 week before surgery may decrease thyroid blood flow, vascularity, and blood loss but does not otherwise influence surgical risk.[1]
- Surgery is recommended for:[2]
- Patients with large goiters
- Women wishing to become pregnant shortly after treatment
- Patients who want to avoid exposure to antithyroid drugs or radioiodine.
- The course of ophthalmopathy is not affected by thyroidectomy.
| Advantages | Disadvantages | |
|---|---|---|
| Thyroidectomy |
|
|
References
- ↑ Erbil Y, Ozluk Y, Giriş M, Salmaslioglu A, Issever H, Barbaros U, Kapran Y, Ozarmağan S, Tezelman S (2007). "Effect of lugol solution on thyroid gland blood flow and microvessel density in the patients with Graves' disease". J. Clin. Endocrinol. Metab. 92 (6): 2182–9. doi:10.1210/jc.2007-0229. PMID 17389702.
- ↑ Bahn RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, Laurberg P, McDougall IR, Montori VM, Rivkees SA, Ross DS, Sosa JA, Stan MN (2011). "Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists". Endocr Pract. 17 (3): 456–520. PMID 21700562.