IS EUTHYROIDISM THE GOAL OF SURGICAL-TREATMENT OF DIFFUSE TOXIC GOITER

Objective. To find out by studying a homogeneous group of patients whe ther euthyroidism is achievable by surgical treatment of diffuse toxic goitre. Design. Retrospective study Setting. Teaching hospital, Italy . Subjects. 128 of the 152 patients operated on for diffuse toxic goit re during the period January 1971-December 1994 and followed up for a median of 83 months (range 6-289). Intervention. Standard subtotal thy roidectomy. Main outcome measures. Operative mortality, recurrence, hy pothyroidism and late complications. Results. There were no operative deaths. After 10 years follow up, 11 patients (9%) had developed recur rences and 61 (48%) were euthyroid. In the univariate analysis the ris k of hypothyroidism was significantly associated with the year of oper ation (p = 0.04), the duration of symptoms (p < 0.01), and the degree of lymphocytic infiltration (p < 0.OI). The last two were confirmed by multivariate analysis. Conclusion. Subtotal thyroidectomy seems to be an effective treatment of diffuse toxic goitre as a stable euthyroid state can be achieved in nearly half the patients after a prolonged fo llow up.