Liechty R D, Silverberg S G, Hernandez J
Arch Surg. 1981 May;116(5):561-5. doi: 10.1001/archsurg.1981.01380170043007.
Limited subtotal thyroidectomy was performed in 42 of 43 patients with Graves' disease. Twenty of 23 patients (87%) who were followed up for an average of 54 months after operation remained euthyroid. Only one patient (4.3%) had recurrent thyrotoxicosis. There were no deaths and no permanent complications. A coexisting, invasive papillary cancer necessitated total thyroidectomy in one patient, and occult papillary cancers were discovered histologically in three others. This study supports the thesis that postoperative thyroid function depends on the volume of remaining thyroid tissue. While preserving thyroid function, limited subtotal thyroidectomy lowers postoperative complications and induces no increase in recurrent thyrotoxicosis.
43例格雷夫斯病患者中有42例行甲状腺次全切除术。23例患者术后平均随访54个月,其中20例(87%)仍保持甲状腺功能正常。仅1例患者(4.3%)出现复发性甲状腺毒症。无死亡病例,也无永久性并发症。1例患者因并存侵袭性乳头状癌而行甲状腺全切除术,另外3例经组织学检查发现隐匿性乳头状癌。本研究支持术后甲状腺功能取决于残留甲状腺组织量这一论点。在保留甲状腺功能的同时,甲状腺次全切除术可降低术后并发症,且不会增加复发性甲状腺毒症的发生率。