{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T08:45:27Z","timestamp":1775292327845,"version":"3.50.1"},"reference-count":61,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Surgical treatment of Graves\u2019 disease (GD) has a potentially increased incidence of postoperative hypoparathyroidism, recurrent laryngeal nerve palsy (RLNP) and bleeding. The aim of this study was to evaluate the current extent of surgery for the treatment of GD and its safety as a short-term outcome. Methods: Patients who underwent thyroid resection for GD were identified from the prospective StuDoQ\/Thyroid registry. Patient data were retrospectively analyzed regarding demographics, surgical procedures and perioperative outcomes. Statistics were performed with Student\u2019s t-test or Fisher\u2019s exact test and multivariate Cox regression analysis. The level of statistical significance was set at p &lt; 0.05. Results: A total of 1808 patients with GD with a median age of 44 (range 14\u201385) years were enrolled in a 25-month period by 78 departments, of which 35.7% (n = 645) had an endocrine orbitopathy and 0.1% (n = 6) had thyrotoxic crisis. Conventional open surgery was used in 98.6% of cases and minimally invasive or remote-access approaches were used in 1.4%. Total thyroidectomy was performed in 93.4% of cases (n = 1688). Intraoperative neuromonitoring (IONM) was used in 98.9% (n = 1789) of procedures. In 98.3% (n = 1777) at least one parathyroid gland was visualized and in 20.7% (n = 375) parathyroids were autografted. The rates of unilateral and bilateral transient RLNP were 3.9% (n = 134\/3429 nerves at risk) and 0.1% (n = 4\/3429 NAR). The rates of transient RLNP tended to be higher when intermittent IONM was used compared to continuous IONM (4.1% vs. 3.4%, p &lt; 0.059). The rate of transient postoperative hypoparathyroidism was overall 29% (n = 525\/1808). Multivariate analysis revealed fewer than 300 thyroid resections and fewer than 15 thyroid resections for GD per year, male sex, BMI &gt; 30, autotransplantation of parathyroid glands and previous bilateral thyroid surgery as independent risk factors for postoperative temporary hypoparathyroidism. Reoperations for bleeding (1.3%) were rare. Conclusion: Total thyroidectomy with IONM is safe and currently the most common surgical therapy for GD in Germany. Postoperative hypoparathyroidism is the major complication which should be focused on.<\/jats:p>","DOI":"10.3390\/jcm9124014","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:45:36Z","timestamp":1607906736000},"page":"4014","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Short-Term Outcomes of Surgery for Graves\u2019 Disease in Germany"],"prefix":"10.3390","volume":"9","author":[{"given":"Elisabeth","family":"Maurer","sequence":"first","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg Baldingerstrasse, 35043 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Vorl\u00e4nder","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, B\u00fcrgerhospital Frankfurt\/Main, 60318 Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7799-4099","authenticated-orcid":false,"given":"Andreas","family":"Zielke","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia","family":"Dotzenrath","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Helios Universityhospital Wuppertal, 42283 Wuppertal, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritz","family":"von Frankenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital Salem-Heidelberg, 69121 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2456-0542","authenticated-orcid":false,"given":"Hinrich","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Herzogin Elisabeth Hospital Braunschweig, 38124 Braunschweig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0281-1950","authenticated-orcid":false,"given":"Kerstin","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery, University Medical Center Halle, 06120 Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresia","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Katholisches Klinikum Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"J\u00e4hne","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Diakovere Henriettenstift Hannover, 30171 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"Hammer","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, DKD Helios Clinic Wiesbaden, 65191 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut A.","family":"B\u00f6ttcher","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Diakonissen Hospital Mannheim, 68163 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Lukas Hospital GmbH Neuss, 41464 Neuss, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Klinger","sequence":"additional","affiliation":[{"name":"German Society of General and Visceral Surgery, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinz J.","family":"Buhr","sequence":"additional","affiliation":[{"name":"German Society of General and Visceral Surgery, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Detlef K.","family":"Bartsch","sequence":"additional","affiliation":[{"name":"Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg Baldingerstrasse, 35043 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"ref_1","first-page":"CD010576","article-title":"Thyroid surgery for Graves\u2019 disease and Graves\u2019 ophthalmopathy","volume":"25","author":"Liu","year":"2015","journal-title":"Cochrane Database Syst. 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