{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:53:40Z","timestamp":1783486420086,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T00:00:00Z","timestamp":1366329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Conducting total thyroidectomy (<jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content>) or subtotal thyroidectomy (<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>) in patients with Graves' disease remains controversial. We performed a meta\u2010analysis based on the published randomized controlled trials to evaluate the complications of <jats:styled-content style=\"fixed-case\">TT <\/jats:styled-content><jats:italic>vs <\/jats:italic><jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched multiple electronic databases for prospective, randomized, controlled trials related to safety and effectiveness of <jats:styled-content style=\"fixed-case\">TT <\/jats:styled-content><jats:italic>vs <\/jats:italic><jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>. Relative risk (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) was estimated with 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) based on an intention\u2010to\u2010treat analysis. We considered the following outcomes: recurrent hyperthyroidism, ophthalmopathy progression, temporary and permanent hypoparathyroidism, temporary and permanent recurrent laryngeal nerve palsy (<jats:styled-content style=\"fixed-case\">RLNP<\/jats:styled-content>) and post\u2010operative bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four trials with 674 patients (342 with <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content>, 332 with <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>) were analysed. Although the overall rates of ophthalmopathy progression were similar between <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0\u00b792, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00\u00b750\u20131\u00b771; <jats:italic>P\u00a0<\/jats:italic>=\u00a00\u00b780), <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> was associated with a significant reduction in recurrent hyperthyroidism (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0\u00b714, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00\u00b705\u20130\u00b741; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701). The pooled <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> of post\u2010operative bleeding for <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> was similar to that for <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0\u00b732, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00\u00b705\u20131\u00b796; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b722). However, comparing with <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>, the <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> of temporary hypoparathyroidism was significantly higher for <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 2\u00b766, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a01\u00b789\u20133\u00b773; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701). There was no significant difference in permanent hypoparathyroidism (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 2\u00b730, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00\u00b778\u20136\u00b776; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b713), temporary (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1\u00b708, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00\u00b747\u20132\u00b748; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b785) and permanent <jats:styled-content style=\"fixed-case\">RLNP<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1\u00b754, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00\u00b741\u20135\u00b773; <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b752) between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With regard to ophthalmopathy progression, post\u2010operative bleeding, permanent hypoparathyroidism, temporary and permanent <jats:styled-content style=\"fixed-case\">RLNP<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> TT<\/jats:styled-content> is consistent with <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content> in patients with Graves' disease. However, <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> is associated with a reduced incidence of recurrent hyperthyroidism and results in an increase in temporary hypoparathyroidism. Therefore, <jats:styled-content style=\"fixed-case\">TT<\/jats:styled-content> should be proposed for the treatment of Graves' disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12209","type":"journal-article","created":{"date-parts":[[2013,3,23]],"date-time":"2013-03-23T21:15:50Z","timestamp":1364073350000},"page":"739-746","source":"Crossref","is-referenced-by-count":61,"title":["Total thyroidectomy <i>vs<\/i> bilateral subtotal thyroidectomy in patients with Graves\u2019 diseases: a meta\u2010analysis of randomized clinical trials"],"prefix":"10.1111","volume":"79","author":[{"given":"Zhenying","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Surgical Pathology Zhejiang Cancer Hospital Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital Harvard Medical School Boston MA 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