Abstract
Either subtotal thyroidectomy or ablation of the gland with131I will lead to a permanent cure of hyperthyroidism. In choosing between these 2 modalities of treatment, several factors should be taken into account, such as the type of goiter, the severity of hyperthyroidism, the size of the gland, age, fitness, and preference of the patient. It is our practice to perform a subtotal thyroidectomy on the young patient with a large gland and severe hyperthyroidism. In the preparation of these patients, thionamides, beta-blockade, and Lugol's iodine are used together until the patient is euthyroid. Preparation with beta-blockade alone led to the only instances of impending storm after surgery in our experience.
Résumé
La thyroïdectome subtotale ou le traitement par l'Iode 131 permettent d'assurer la guérison définitive de l'hyperthyroïdisme. Le choix entre les deux modalités thérapeutiques dépend du type du goître, de la gravité de l'hyperthyroïdie, du volume de la glande, de l'âge et aussi des désirs du malade.
Chez le sujet jeune qui présente un volumineux goitre et une hyperthyroïdie sévère les auteurs donnent leur préférence au traitement chirurgical. Le malade est préparé par l'administration conjointe de thionamides, de béta-bloquants et de solution de Lugol de façon à parvenir à un état d'euthyroïdie. La préparation à l'aide exlusive des bétabloquants est insuffisante; elle a été suivie parfois par un “orage thyroïdien post-opératoire.”
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Mieny, C.J., Franz, R.C. & Venter, I.D. The management of severe hyperthyroidism. World J. Surg. 6, 689–695 (1982). https://doi.org/10.1007/BF01655360
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DOI: https://doi.org/10.1007/BF01655360