Thyroidectomy for Graves’ Disease Rapidly Improves Symptoms and Quality of Life

2022 ◽  
Vol 34 (1) ◽  
pp. 17-19
Author(s):  
Lilah F. Morris-Wiseman
Endocrine ◽  
2018 ◽  
Vol 63 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Cínthia Minatel Riguetto ◽  
Arnaldo Moura Neto ◽  
Marcos Antônio Tambascia ◽  
Denise Engelbrecht Zantut-Wittmann

2016 ◽  
pp. 54-56
Author(s):  
S. I. Ismailov ◽  
N. B. Ubaydullaeva ◽  
U. Z. Mirzaeva

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Christopher W Rowe ◽  
Nicholas D Blefari ◽  
Natalie Rutherford ◽  
Cino Bendinelli ◽  
Chris O’Neill

Abstract Introduction: Quality of Life (QoL) is reduced in patients with Graves’ disease, however the impact of treatment modality is unclear, with conflicting evidence from recent studies (1–3). We hypothesized that surgery would have a greater impact than radioiodine on QoL in Graves’ disease, especially with regard to the physical-symptom subdomain. Methods: Patients treated with thyroid surgery for benign disease (n=425) or radioactive iodine for hyperthyroidism (n=1637) at a single tertiary institution between 2000 and 2017 were invited to complete a validated thyroid-specific QoL instrument (City of Hope), reporting scores 0–10, where higher scores are associated with greater QoL. Responses were received from 307 patients, of whom 114 (37%) had Graves’ disease, treated with total thyroidectomy (n=23) or doses of 15mCi (550MBq) radioiodine (n=91, including 19 patients receiving 2 or more doses). The results of patients with Graves’ disease are reported here. Medians [interquartile ranges] are compared with the Mann-Whitney test (alpha 0.05). Results: 85% of respondents were female, with no difference in gender between groups (p=0.11). Thyroidectomy patients were more likely to be younger (36 [31–49] vs 50 [39–59] years, p=0.004); and have a shorter duration between treatment and survey (5.9 [2.4–9.6] vs 7.6 [4.9–11.6] years, p=0.04). No overall QoL deficit was seen in patients treated with surgery compared to radioiodine (6.8 [5.2–7.3] vs 7.0 [5.8–8.1], p=0.08). However, patients treated with surgery reported reduce QoL in psychological (6.6 [4.7–7.5] vs 7.0 [5.9–8.2] p=0.05) and social (7.9 [6.4 – 8.9] vs 8.9 [7.4–9.8] p=0.01) subdomains compared to radioiodine-only treated patients. Within the social subdomain, the QoL detriment was driven by lower scores relating to questions regarding impact on personal and family relationships, support, and isolation (p<0.001), and not by impact on activities of daily living or employment concerns. Interestingly, there was no between group difference in the physical symptom subdomain (p=0.16). QoL differences between treatment modalities were preserved when patients receiving multiple doses of radioiodine were excluded. Discussion In this non-randomised cross-sectional study from a tertiary-hospital population in Australia, a QoL deficit was demonstrable in subdomain scores for patients with Graves’ disease treated with surgery compared to radioiodine, although the overall result was not significantly different. Better understanding of patient experiences is required to guide treatment strategies and appropriately counsel patients. References (1) Torring et al. Thyroid. 2019;29(3):322–31. (2) Abraham-Nordling et al. Thyroid. 2005;15(11):1279–86. (3) Ljunggren et al. Thyroid. 1998;8(8):653–9.


2019 ◽  
Vol 9 (1) ◽  
pp. 26-30
Author(s):  
S. N. Styazhkina ◽  
A. V. Ledneva ◽  
E. L. Poryvaeva

Introduction. Graves’ disease is a disorder associated with thyroid gland producing excessive amounts of hormones which causes changes in the functional status of various organs and systems. Among thyroid disorders it takes the second place (after endemic goitre) in prevalence. Until now, there is no consensus on a single strategy for the treatment of disorders of the thyroid gland. This is why this paper aims to assess the impact of surgical treatment of Graves’ disease on patients’ quality of life and whether it would be possible to improve it by following the surgery with hormone replacement therapy.Materials and methods. This paper presents a retrospective analysis of 70 case histories of patients who received surgical treatment for diffuse toxic goitre at the BIH UR “First Republican Teaching Hospital” MH UR,Izhevsk, in the period from 2008 to 2014. Percentages of the disease by stage were as follows: stage II — 20%, stage III — 70%, stage 4 — 10%. One lobe resection was performed in 3% of patients, two lobe resection — in 1%, hemithyroidectomy — in 18±4.6%, subtotal resection — in 8%, thyroidectomy — in 70±5.5%.Results. Percentages of patients with various degrees of severity of postoperative hypothyroidism were as follows: severe — 66%, medium — 29%, light — 5%; there were no Graves’ disease recurrences. Patients’ complaints following thyroidectomy included body weight gain — 79.1±4.8%, cold in extremities — 83.3±4.4%, cardiac arrhythmia — 85.2±4.2%, oedemas — 84.3±4.3%, drowsiness, atonia — 67.1±5.6%, changes in appetite — 21±4.8%, skin pallor — 47.6±5.9%, brittle nails, hair loss — 51.2±5.9%, joint pain — 31.2±5.53%.Conclusion. Hypothyroidism always follows thyroidectomy and requires ongoing hormone replacement therapy with L-thyroxine. Th quality of life does not have to suffer if an individual dosage is established and followed on a permanent basis.


2017 ◽  
Vol 61 (4) ◽  
pp. 374-381 ◽  
Author(s):  
Laura Carolina Delfino ◽  
Anabela Zunino ◽  
Verónica Sapia ◽  
María del Carmen Silva Croome ◽  
Verónica Ilera ◽  
...  

2016 ◽  
pp. 54-56
Author(s):  
S. I. Ismailov ◽  
N. B. Ubaydullaeva ◽  
U. Z. Mirzaeva

Author(s):  
Diana Grove-Laugesen ◽  
Cramon Per Karkov ◽  
Eva Ebbehoj ◽  
Hansen Klavs Würgler ◽  
Lars Rejnmark ◽  
...  

2018 ◽  
Vol 88 (6) ◽  
pp. 977-984 ◽  
Author(s):  
Helen M. Conaglen ◽  
Jade A. U. Tamatea ◽  
John V. Conaglen ◽  
Marianne S. Elston

2017 ◽  
Vol 96 (4-5) ◽  
pp. E8-E9 ◽  
Author(s):  
Lukas H. Kus ◽  
Wilma M. Hopman ◽  
Ian J. Witterick ◽  
Jeremy L. FreemanFreemanFreeman

Historically, research into surgical treatment of Graves disease has assessed subtotal rather than total thyroidectomy. Most clinicians now recommend total thyroidectomy, but little information is available regarding quality-of-life (QOL) outcomes for this procedure. Our aim was to assess QOL after total thyroidectomy. This is a retrospective, pilot study of patients with Graves disease who underwent total thyroidectomy from 1991 to 2007 at a high-volume tertiary referral center in Toronto, Canada. Questionnaires addressing disease-specific symptoms and global QOL concerns were sent to 54 patients. Analyses included parametric and nonparametric tests to assess the differences between perception of symptoms and global QOL before and after surgery. Forty patients responded (response rate: 74%) at a median of 4.8 years postoperatively. On a 10-point scale, overall wellness improved from 4.1 pre-operatively to 8.7 postoperatively (p < 0.001). Patients recalled missing less work or school after surgery (7.8 vs. 1.1 days/year; p = 0.001). Overall satisfaction with the procedure was high. On average, symptoms improved within 32 days of surgery, and all symptoms showed substantial improvement. This is the first North American study to assess QOL outcomes of patients with Graves disease after total thyroidectomy. Patients experienced marked and rapid improvement in QOL postoperatively. These findings suggest that total thyroidectomy is a safe and effective treatment.


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