Mimura T, Ito K
Department of Surgery, Ito Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2000 Dec;101(12):824-6.
In the late 19th century, surgeons in central Europe attempted to perform thyroidectomy for Graves' disease. Theodor Billroth, Theodor Kocher, and their colleagues made numerous contributions to progress in surgical methods. Preoperative arterial ligation, lobectomy, and second-stage operations were performed to reduce operative mortality rates. Lobectomy and partial resection of the contralateral lobe were performed in the 1900s, and subtotal thyroidectomy, which became the standard procedure of the day, was performed in the 1920s. Developments in medical therapy, such as iodine (1923) and thiouracil (1943) administration, also decreased postoperative mortality and morbidity rates. In 1954, radioiodine therapy was found to yield satisfactory results in achieving remission of Graves' disease. Currently, surgery for Graves' disease is indicated only in patients with large goiters or who require rapid remission.
19世纪后期，中欧的外科医生尝试对格雷夫斯病患者进行甲状腺切除术。西奥多·比尔罗特、西奥多·科赫以及他们的同事在手术方法的进步方面做出了诸多贡献。他们进行了术前动脉结扎、叶切除术和二期手术，以降低手术死亡率。20世纪初开展了叶切除术和对侧叶部分切除术，20世纪20年代进行了甲状腺次全切除术，该手术成为当时的标准术式。医学治疗方面的进展，如碘（1923年）和硫脲嘧啶（1943年）的应用，也降低了术后死亡率和发病率。1954年，发现放射性碘治疗在实现格雷夫斯病缓解方面能产生令人满意的效果。目前，格雷夫斯病手术仅适用于甲状腺肿大较大或需要快速缓解的患者。
