Abstract
Whenever there are alternative methods of treatment, one surgical and the other nonsurgical, and when each method is equally effective, the nonsurgical method invariably prevails. Patients dislike surgery and so do the internists whom they first consult. There seems to be no question that thyroidectomy for Graves' disease and its complications of vocal cord paralysis, tetany, hypothyroidism, recurrent hyperthyroidism, unsightly scar, and accidental death will soon be things of the past.131I involves no risk, and the only side effect or complication is preventable hypothyroidism. If the facts of the case were explained to the patients, none of them would choose thyroidectomy over treatment with131I. It is the responsibility of the physician to tell the patient the facts.
Résumé
Lorsqu'il existe deux possibilités thérapeutiques, l'une chirurgicale et l'autre non chirurgicale, toutes deux également efficaces, il fault toujours préférer la méthode non chirurgicale. Les malades et leurs médecins traitants n'aiment pas la chirurgie. Il parait évident que, dans un avenir plus ou moins proche, la thyroïdectomie ne sera plus utilisée comme traitement de la maladie de Basedow et qu'on verra donc disparaître ses complications de paralysie des cordes vocales, tétanie, hypothyroïdie, récidive d'hyperthyroïdie, cicatrices inesthétiques et décès accidentels postopératoires. Le traitement à131I est sans danger, sa seule complication, l'hypothyroïdie, pouvant être prévenue. Si l'on disait la vérité aux malades, aucun ne préférerait la thyroïdectomie au131I. Cette information est la responsabilité des médecins.
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References
Crile, G., Jr., Skillern, P.G.: Advantages of radioiodine over thyroidectomy in the treatment of Graves' disease. Cleve. Clin. Q.35:73, 1968
Safa, A.M., Skillern, P.G.: Treatment of hyperthyroidism with a large initial dose of sodium iodide131I. Arch. Intern. Med.135:613, 1975
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Crile, G. The treatment of hyperthyroidism. World J. Surg. 2, 279–280 (1978). https://doi.org/10.1007/BF01561491
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DOI: https://doi.org/10.1007/BF01561491