{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:17:57Z","timestamp":1793845077336,"version":"4.6.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2002,5,27]],"date-time":"2002-05-27T00:00:00Z","timestamp":1022457600000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2002,5]]},"abstract":"<jats:p><jats:bold>Purpose:\u2002<\/jats:bold> Subtotal thyroidectomy has been advocated as the standard treatment for Graves\u2019 disease because of the possibility of avoiding thyroxine therapy as well as the assumed lower risk of complications compared to total thyroidectomy. However, the long\u2010term results of subtotal thyroidectomy are not as good as they were previously believed to be, as evidenced by the increasing incidence of hypothyroidism. If the risk of complications from total thyroidectomy is no higher, then that procedure offers significant advantages in the surgical management of Graves\u2019 disease. The aim of this study therefore was to compare the complication rate of the two procedures in patients with Graves\u2019 disease.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> This was a retrospective case control study in a tertiary referral hospital. Information was obtained from an endocrine surgery database over the study period from January 1957 to December 2000. During that period 1246 patients with Graves\u2019 disease underwent subtotal thyroidectomy and 119 patients underwent total thyroidectomy.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Prior to 1987 total thyroidectomy was rarely if ever performed whereas in the last 12\u2003months total thyroidectomy comprised 95% of all procedures. There was no significant difference in the rate of permanent complications between the two procedures although temporary hypocalcaemia was significantly more common following total thyroidectomy. Permanent hypoparathyroidism resulted in one patient each who underwent total thyroidectomy (0.8%) and subtotal thyroidectomy (0.1%). Permanent recurrent laryngeal nerve palsy occurred in one patient who underwent total thyroidectomy (0.8%) and 5 patients undergoing subtotal thyroidectomy (0.4%).<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Given that subtotal thyroidectomy provides an unpredictable outcome and that the risk of permanent complications is no greater than with total thyroidectomy, there appears little logical reason to continue to recommend subtotal thyroidectomy for the surgical management of Graves\u2019 disease. We believe that Graves\u2019 disease should join the increasing list of thyroid conditions for which total thyroidectomy is the preferred option.<\/jats:p>","DOI":"10.1046\/j.1445-2197.2002.02400.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T02:49:26Z","timestamp":1047350966000},"page":"321-324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Total thyroidectomy is now the preferred option for the surgical management of Graves\u2019 disease"],"prefix":"10.1111","volume":"72","author":[{"given":"Michael S.","family":"Barakate","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom S.","family":"Reeve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Barraclough","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh W.","family":"Delbridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,5,27]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s101160050021"},{"key":"e_1_2_5_3_2","first-page":"136","article-title":"InvitedCommentary: Progressive increase in thyroid dysfunction after subtotalthyroidectomy for Graves\u2019\u00addisease","volume":"23","author":"Thompson N","year":"2000","journal-title":"Asian J. Surg."},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010158"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(96)80049-3"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1320406"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.12.1389"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680020100"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.1999.01697.x"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010173"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1006\/jsre.2000.5875"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(88)80060-6"},{"key":"e_1_2_5_13_2","first-page":"327","article-title":"Clinicalevaluation of the response to surgical treatment of Graves\u2019 disease","volume":"170","author":"Kasuga Y","year":"1990","journal-title":"Surg. Gynecol. Obstet."},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800740909"},{"key":"e_1_2_5_15_2","first-page":"87","article-title":"Thyroidectomyfor Graves\u2019 disease: Is hypo\u00adthyroidism inevitable?","volume":"71","author":"Davenport M","year":"1989","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199708)19:5<378::AID-HED3>3.0.CO;2-X"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90088-4"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801083380201"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198911163212001"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199206253262603"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.79.2.542"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)90288-2"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/imj.1968.17.4.307"},{"key":"e_1_2_5_24_2","first-page":"432","article-title":"Malignant exophthalmos after iodine\u2010131treatment","volume":"14","author":"Aron\u2010Rosa D","year":"1973","journal-title":"Mod. Probl. Ophthalmol."},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900458"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800800921"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1445-2197.2002.02400.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1445-2197.2002.02400.x","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1046\/j.1445-2197.2002.02400.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T09:09:04Z","timestamp":1698743344000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1046\/j.1445-2197.2002.02400.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,5]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2002,5]]}},"alternative-id":["10.1046\/j.1445-2197.2002.02400.x"],"URL":"https:\/\/doi.org\/10.1046\/j.1445-2197.2002.02400.x","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,5]]},"assertion":[{"value":"2002-05-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}