{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:52:35Z","timestamp":1789102355503,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,12,23]],"date-time":"2009-12-23T00:00:00Z","timestamp":1261526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the United States, Graves\u2019 disease is most commonly treated with radioiodine, yet thyroidectomy remains an important option for correcting hyperthyroidism. In many countries, limited access to thyroid hormone makes subtotal thyroidectomy the procedure of choice. In the United States, where levothyroxine is widely available, we hypothesized that total (TT) or near\u2010total thyroidectomy (NT) is superior to subtotal thyroidectomy (ST) for long\u2010term control of Graves\u2019 disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients who underwent ST, NT, or TT for Graves\u2019 disease between 1990 and 2008 was conducted. Differences in rates of disease recurrence were assessed by analysis of variance (ANOVA). Rates of parathyroid autotransplantation, complications, gland weight, and final pathology were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 136 patients with Graves\u2019 disease were treated with thyroidectomy. Average age was 36.4 \u00b1 11.3 years (range: 16\u201381 years) and 88% were female. From 1990 to 1994, 10 patients underwent ST and 6 had NT. Since then, all patients have undergone TT (<jats:italic>n<\/jats:italic> = 120). There was a significantly higher rate of recurrence for ST (30%) compared to NT (0%; <jats:italic>P<\/jats:italic> = 0.15) and TT (0%; <jats:italic>P<\/jats:italic> &lt; 0.0001). Parathyroid autotransplantation was performed in 36 (26.5%) patients, only 2 of whom underwent ST or NT. Transient postoperative hypocalcemia was more common after TT (<jats:italic>P<\/jats:italic> = 0.04). No patient in any group had permanent hypoparathyroidism. Two TT pts had transient recurrent laryngeal nerve palsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Subtotal thyroidectomy resulted in 30% long\u2010term failure to correct Graves\u2019 hyperthyroidism. We saw no recurrences and no increase in postoperative complications in the TT group. We feel that TT is safe and superior to ST for management of Graves\u2019 disease in the United States.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-009-0337-3","type":"journal-article","created":{"date-parts":[[2009,12,22]],"date-time":"2009-12-22T17:11:52Z","timestamp":1261501912000},"page":"1261-1264","source":"Crossref","is-referenced-by-count":79,"title":["Total Thyroidectomy Is Superior to Subtotal Thyroidectomy for Management of Graves\u2019 Disease in the United States"],"prefix":"10.1002","volume":"34","author":[{"given":"Scott M.","family":"Wilhelm","sequence":"first","affiliation":[{"name":"Department of Surgery University Hospitals\/Case Medical Center 11100 Euclid Avenue 44106 Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"McHenry","sequence":"additional","affiliation":[{"name":"Department of Surgery MetroHealth Medical Center 2500 MetroHealth Drive 44109 Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,12,23]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"515","article-title":"Clinical lectures","volume":"7","author":"Graves RJ","year":"1835","journal-title":"Lond Med Surg"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1997.4412"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.81.8.2986"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(96)80049\u20103"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/014107689809133S02"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010216"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445\u20102197.2005.03441.x"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina44010004"},{"key":"e_1_2_5_10_2","first-page":"10","article-title":"Surgery for Grave\u2019s disease. A review of 378 cases","volume":"86","author":"Le Clech G","year":"2005","journal-title":"Fr ORL"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2005.15.569"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.K07E\u2010013"},{"key":"e_1_2_5_13_2","unstructured":"World Health Organization(2008)Medicine prices availability affordability and price components. WHO Document no. 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