Surgery for Graves’ disease: a 25-year perspective
Abstract Background Optimal treatment of Graves’ disease (GD) remains controversial. The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center. Methods Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy ov...
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| Veröffentlicht in: | The American journal of surgery 2013-11, Vol.206 (5), p.669-673 |
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| creator | Phitayakorn, Roy, M.D., M.H.P.E Morales-Garcia, Dieter, M.D Wanderer, Jonathan, M.D Lubitz, Carrie C., M.D., M.P.H Gaz, Randall D., M.D Stephen, Antonia E., M.D Ehrenfeld, Jesse M., M.D Daniels, Gilbert H., M.D Hodin, Richard A., M.D Parangi, Sareh, M.D |
| description | Abstract Background Optimal treatment of Graves’ disease (GD) remains controversial. The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center. Methods Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy over 25 years, in 3 periods: 1985 to 1993 (n = 32), 1994 to 2002 (n = 91), and 2003 to 2010 (n = 177). Results There were 300 patients with GD (85.7% women; mean age, 39.3 years; median length of follow-up, 24.6 months). Overall, perioperative morbidity occurred in 36 patients (12.0%), and there was no mortality. Thyroidectomy-specific morbidity was very low, and the incidental malignancy rate was 10.3%. Conclusions Surgical treatment of GD has a very high safety profile, with low perioperative and thyroidectomy-specific morbidity, even in patients with overt hyperthyroidism. Incidental malignancy in patients with GD is not uncommon. |
| doi_str_mv | 10.1016/j.amjsurg.2013.07.005 |
| format | Article |
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The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center. Methods Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy over 25 years, in 3 periods: 1985 to 1993 (n = 32), 1994 to 2002 (n = 91), and 2003 to 2010 (n = 177). Results There were 300 patients with GD (85.7% women; mean age, 39.3 years; median length of follow-up, 24.6 months). Overall, perioperative morbidity occurred in 36 patients (12.0%), and there was no mortality. Thyroidectomy-specific morbidity was very low, and the incidental malignancy rate was 10.3%. Conclusions Surgical treatment of GD has a very high safety profile, with low perioperative and thyroidectomy-specific morbidity, even in patients with overt hyperthyroidism. Incidental malignancy in patients with GD is not uncommon.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2013.07.005</identifier><identifier>PMID: 24011567</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Ablation Techniques - trends ; Adult ; Age ; Antithyroid Agents - therapeutic use ; Drainage - trends ; Electronic monitoring ; Female ; Gender ; Graves Disease - surgery ; Graves’ disease ; Hospitals ; Humans ; Hyperthyroidism ; Incidental Findings ; Incidental malignancy ; Iodine Radioisotopes - therapeutic use ; Length of Stay - trends ; Male ; Massachusetts ; Methimazole - therapeutic use ; Monitoring systems ; Morbidity ; Operative Time ; Pathology ; Patients ; Postoperative Complications ; Preoperative Care ; Propylthiouracil - therapeutic use ; Retrospective Studies ; Statistical analysis ; Surgery ; Surgical therapy ; Thyroid Neoplasms - epidemiology ; Thyroidectomy - trends ; Variables</subject><ispartof>The American journal of surgery, 2013-11, Vol.206 (5), p.669-673</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jan 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-6d957987f9ae5e6a7f4627dee9dd1136de24fae2ae08b2d97461f74221b42c1b3</citedby><cites>FETCH-LOGICAL-c448t-6d957987f9ae5e6a7f4627dee9dd1136de24fae2ae08b2d97461f74221b42c1b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1443709592?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24011567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Phitayakorn, Roy, M.D., M.H.P.E</creatorcontrib><creatorcontrib>Morales-Garcia, Dieter, M.D</creatorcontrib><creatorcontrib>Wanderer, Jonathan, M.D</creatorcontrib><creatorcontrib>Lubitz, Carrie C., M.D., M.P.H</creatorcontrib><creatorcontrib>Gaz, Randall D., M.D</creatorcontrib><creatorcontrib>Stephen, Antonia E., M.D</creatorcontrib><creatorcontrib>Ehrenfeld, Jesse M., M.D</creatorcontrib><creatorcontrib>Daniels, Gilbert H., M.D</creatorcontrib><creatorcontrib>Hodin, Richard A., M.D</creatorcontrib><creatorcontrib>Parangi, Sareh, M.D</creatorcontrib><title>Surgery for Graves’ disease: a 25-year perspective</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Optimal treatment of Graves’ disease (GD) remains controversial. The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center. Methods Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy over 25 years, in 3 periods: 1985 to 1993 (n = 32), 1994 to 2002 (n = 91), and 2003 to 2010 (n = 177). Results There were 300 patients with GD (85.7% women; mean age, 39.3 years; median length of follow-up, 24.6 months). Overall, perioperative morbidity occurred in 36 patients (12.0%), and there was no mortality. Thyroidectomy-specific morbidity was very low, and the incidental malignancy rate was 10.3%. Conclusions Surgical treatment of GD has a very high safety profile, with low perioperative and thyroidectomy-specific morbidity, even in patients with overt hyperthyroidism. Incidental malignancy in patients with GD is not uncommon.</description><subject>Ablation Techniques - trends</subject><subject>Adult</subject><subject>Age</subject><subject>Antithyroid Agents - therapeutic use</subject><subject>Drainage - trends</subject><subject>Electronic monitoring</subject><subject>Female</subject><subject>Gender</subject><subject>Graves Disease - surgery</subject><subject>Graves’ disease</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperthyroidism</subject><subject>Incidental Findings</subject><subject>Incidental malignancy</subject><subject>Iodine Radioisotopes - therapeutic use</subject><subject>Length of Stay - trends</subject><subject>Male</subject><subject>Massachusetts</subject><subject>Methimazole - therapeutic use</subject><subject>Monitoring systems</subject><subject>Morbidity</subject><subject>Operative Time</subject><subject>Pathology</subject><subject>Patients</subject><subject>Postoperative Complications</subject><subject>Preoperative Care</subject><subject>Propylthiouracil - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical therapy</subject><subject>Thyroid Neoplasms - epidemiology</subject><subject>Thyroidectomy - trends</subject><subject>Variables</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkcFu1DAQhq2qiC6FR2gVqRcuCTO2E8ccQKiCglSJQ-Fsee1J5ZDdbO3NSnvjNXg9ngRHuwWpF04eS9_8Hn_D2AVChYDNm76yqz5N8b7igKICVQHUJ2yBrdIltq04ZQsA4KVuEM7Yi5T6fEWU4jk74zJXdaMWTN7lCIr7ohtjcRPtjtLvn78KHxLZRG8LW_C63JONxYZi2pDbhh29ZM86OyR6dTzP2fdPH79dfy5vv958uf5wWzop223ZeF0r3apOW6qpsaqTDVeeSHuPKBpPXHaWuCVol9xrJRvslOQcl5I7XIpz9vqQu4njw0Rpa1YhORoGu6ZxSgalrDVyFCqjV0_QfpziOk83U0KBrjXPVH2gXBxTitSZTQwrG_cGwcxaTW-OWs2s1YAyWWvuuzymT8sV-b9djx4z8P4AUNaxCxRNcoHWjnyI2ZnxY_jvE--eJLghrIOzww_aU_r3G5O4AXM373ZeLQoAmUvxByGOnsE</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Phitayakorn, Roy, M.D., M.H.P.E</creator><creator>Morales-Garcia, Dieter, M.D</creator><creator>Wanderer, Jonathan, M.D</creator><creator>Lubitz, Carrie C., M.D., M.P.H</creator><creator>Gaz, Randall D., M.D</creator><creator>Stephen, Antonia E., M.D</creator><creator>Ehrenfeld, Jesse M., M.D</creator><creator>Daniels, Gilbert H., M.D</creator><creator>Hodin, Richard A., M.D</creator><creator>Parangi, Sareh, M.D</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20131101</creationdate><title>Surgery for Graves’ disease: a 25-year perspective</title><author>Phitayakorn, Roy, M.D., M.H.P.E ; Morales-Garcia, Dieter, M.D ; Wanderer, Jonathan, M.D ; Lubitz, Carrie C., M.D., M.P.H ; Gaz, Randall D., M.D ; Stephen, Antonia E., M.D ; Ehrenfeld, Jesse M., M.D ; Daniels, Gilbert H., M.D ; Hodin, Richard A., M.D ; Parangi, Sareh, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-6d957987f9ae5e6a7f4627dee9dd1136de24fae2ae08b2d97461f74221b42c1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Ablation Techniques - trends</topic><topic>Adult</topic><topic>Age</topic><topic>Antithyroid Agents - therapeutic use</topic><topic>Drainage - trends</topic><topic>Electronic monitoring</topic><topic>Female</topic><topic>Gender</topic><topic>Graves Disease - surgery</topic><topic>Graves’ disease</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperthyroidism</topic><topic>Incidental Findings</topic><topic>Incidental malignancy</topic><topic>Iodine Radioisotopes - therapeutic use</topic><topic>Length of Stay - trends</topic><topic>Male</topic><topic>Massachusetts</topic><topic>Methimazole - therapeutic use</topic><topic>Monitoring systems</topic><topic>Morbidity</topic><topic>Operative Time</topic><topic>Pathology</topic><topic>Patients</topic><topic>Postoperative Complications</topic><topic>Preoperative Care</topic><topic>Propylthiouracil - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical therapy</topic><topic>Thyroid Neoplasms - epidemiology</topic><topic>Thyroidectomy - trends</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Phitayakorn, Roy, M.D., M.H.P.E</creatorcontrib><creatorcontrib>Morales-Garcia, Dieter, M.D</creatorcontrib><creatorcontrib>Wanderer, Jonathan, M.D</creatorcontrib><creatorcontrib>Lubitz, Carrie C., M.D., M.P.H</creatorcontrib><creatorcontrib>Gaz, Randall D., M.D</creatorcontrib><creatorcontrib>Stephen, Antonia E., M.D</creatorcontrib><creatorcontrib>Ehrenfeld, Jesse M., M.D</creatorcontrib><creatorcontrib>Daniels, Gilbert H., M.D</creatorcontrib><creatorcontrib>Hodin, Richard A., M.D</creatorcontrib><creatorcontrib>Parangi, Sareh, M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Phitayakorn, Roy, M.D., M.H.P.E</au><au>Morales-Garcia, Dieter, M.D</au><au>Wanderer, Jonathan, M.D</au><au>Lubitz, Carrie C., M.D., M.P.H</au><au>Gaz, Randall D., M.D</au><au>Stephen, Antonia E., M.D</au><au>Ehrenfeld, Jesse M., M.D</au><au>Daniels, Gilbert H., M.D</au><au>Hodin, Richard A., M.D</au><au>Parangi, Sareh, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgery for Graves’ disease: a 25-year perspective</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>206</volume><issue>5</issue><spage>669</spage><epage>673</epage><pages>669-673</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Abstract Background Optimal treatment of Graves’ disease (GD) remains controversial. The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center. Methods Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy over 25 years, in 3 periods: 1985 to 1993 (n = 32), 1994 to 2002 (n = 91), and 2003 to 2010 (n = 177). Results There were 300 patients with GD (85.7% women; mean age, 39.3 years; median length of follow-up, 24.6 months). Overall, perioperative morbidity occurred in 36 patients (12.0%), and there was no mortality. Thyroidectomy-specific morbidity was very low, and the incidental malignancy rate was 10.3%. Conclusions Surgical treatment of GD has a very high safety profile, with low perioperative and thyroidectomy-specific morbidity, even in patients with overt hyperthyroidism. Incidental malignancy in patients with GD is not uncommon.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24011567</pmid><doi>10.1016/j.amjsurg.2013.07.005</doi><tpages>5</tpages></addata></record> |
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| subjects | Ablation Techniques - trends Adult Age Antithyroid Agents - therapeutic use Drainage - trends Electronic monitoring Female Gender Graves Disease - surgery Graves’ disease Hospitals Humans Hyperthyroidism Incidental Findings Incidental malignancy Iodine Radioisotopes - therapeutic use Length of Stay - trends Male Massachusetts Methimazole - therapeutic use Monitoring systems Morbidity Operative Time Pathology Patients Postoperative Complications Preoperative Care Propylthiouracil - therapeutic use Retrospective Studies Statistical analysis Surgery Surgical therapy Thyroid Neoplasms - epidemiology Thyroidectomy - trends Variables |
| title | Surgery for Graves’ disease: a 25-year perspective |
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