Endocrine Abstracts

The incidence of Graves disease in different regions of Russia ranges from 20 to 50 cases per 100000 population.

Purpose: To improve the results of surgical treatment of patients with Graves disease by identifying the optimum amount of remaining thyroid tissue and prediction of thyroidal status in the long term.

Methods and design: The 138 patients with Graves disease operated over the past 10 years: 131 women (94.9%) and 7 men (5.1%). The operations performed on classic method - subtotal subfascial resection thyroid by O.V.Nikolaev (1951).

Results: Euthyroid status was detected in 68 (49.2%) patients. The signs of subclinical hypothyroidism found at 30 (21.7%) patients. The 25 patients (18.2%) have postoperative hypothyroidism; 15 patients (10.9%) have recurrence of hyperthyroidism. The main cause of relapse of hyperthyroidism was saving on operation the part of thyroid more than 8–19 g.

Conclusion: The study allowed to select prognostic criteria, bearing in mind that it is possible to achieve euthyroid condition.

1. Volume of leaving thyroid tissue for patients older than 40 years must be 6 g, but for the patients younger 40 years – no more 4 g.

2. The duration of conservative antithyroidal therapy should not exceed 1 year. Recurrence of the Graves disease after abolition of antithyroid drugs is the indication for surgical treatment

3. The high level of thyroid antibody (Thyroid Peroxidase Antibody≥600 IU/ml and/or Antithyroglobulin Antibody ≥ 300 IU/ml) is the main if thyroid tissue is smaller that 4 g.

4. Thyroid tissue with volume less than 2 gramm no able to meet the physiological needs of man in thyroid hormones