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Early Timing of Thyroidectomy for Hyperthyroidism in Graves’ Disease Improves Biochemical Recovery

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Abstract

Background

The role of thyroidectomy as an early treatment for hyperthyroidism has been poorly investigated. Our aim was to examine its success rates, particularly focusing on thyroidectomy as an early treatment.

Methods

Patients with thyroidectomy for hyperthyroidism between February 2008 and October 2014 were included. They were divided into two groups (early and delayed thyroidectomy), and patient characteristics, treatment indications, complications and time to biochemical recovery were analyzed.

Results

Ninety-nine patients met the inclusion criteria, of whom 65 (66%) suffered from Graves’ disease, 25 (25%) from toxic goiters and 9 (9%) from amiodarone-induced hyperthyroidism. Structural abnormalities of the thyroid (39 patients, 39%) represented the most frequent indications for thyroidectomy. Forty-six patients (46%) underwent an early and 53 (54%) a delayed surgical approach. Patients with Graves’ disease undergoing early thyroidectomy did not suffer more often from complications but had a significantly faster biochemical recovery after surgery than those with a delayed thyroidectomy, as judged by a shorter time to reach TSH (121 ± 24 vs. 240 ± 31 days, p = 0.007) and fT4 (91 ± 29 vs. 183 ± 31 days p = 0.015) levels in the normal range. As expected, there were no recurrences of hyperthyroidism.

Conclusions

Early thyroidectomy was neither associated with permanent complications nor thyroid storm, but with a significantly improved biochemical recovery and therefore has to be recommended early in patients with Graves’ disease.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland

    Domenic Vital, Grégoire B. Morand, Christian Meerwein, Roman D. Laske & Gerhard F. Huber

  2. Department of Nuclear Medicine, University Hospital Zurich and University of Zurich, Raemistasse 100, 8091, Zurich, Switzerland

    Hans C. Steinert

  3. Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich and University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Christoph Schmid

  4. Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Michelle L. Brown

Authors
  1. Domenic Vital
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  2. Grégoire B. Morand
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  3. Christian Meerwein
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  4. Roman D. Laske
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  5. Hans C. Steinert
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  6. Christoph Schmid
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  7. Michelle L. Brown
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  8. Gerhard F. Huber
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Corresponding author

Correspondence to Gerhard F. Huber.

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The authors declare that they have no competing interests.

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Vital, D., Morand, G.B., Meerwein, C. et al. Early Timing of Thyroidectomy for Hyperthyroidism in Graves’ Disease Improves Biochemical Recovery. World J Surg 41, 2545–2550 (2017). https://doi.org/10.1007/s00268-017-4052-1

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  • DOI: https://doi.org/10.1007/s00268-017-4052-1

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