[Postoperative complications and long-term results of the surgical treatment of immunogenic Basedow's disease].

BACKGROUND AND OBJECTIVE

The surgical options for immunogenic Grave's disease (hyperthyroidism with ophthalmopathy) are not uniform. This study was undertaken to compare the effectiveness of several types of operation.

PATIENTS AND METHODS

In a retrospective study the data on 99 patients with Grave's disease (aged 10 to 71 years, mean 35 years), operated on from 1987 to 1996 by 28 different surgeons, were analysed. Follow-up examinations were then undertaken a mean of 42 months (range of 12-108 months) postoperatively.

RESULTS

Bilateral subtotal thyroid resection had been performed in 45 patients, unilateral subtotal resection with contralateral hemithyroidectomy in 49 and total thyroidectomy in five. Re-operation for postoperative bleeding was necessary in three patients. At follow-up two patients were found to have recurrent nerve palsy. Four patients had to be treated for mild chronic hyperparathyroidism. There was no significant difference between the different operation regarding type and frequency of complications. At following-up examination none of the patients had hyperthyroidism. 37 of 50 patients with endocrine ophthalmopathy were improved after the operation.

CONCLUSIONS

With a standardized operative technique and retention of less than 6 g of thyroid tissue a recurrence of hyperthyroidism can be reliably prevented. This form of treatment can be achieved with an acceptable complication rate, which is unrelated to the type of operation.