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• W4237590436 abstract "We appreciate the interest of Mishra et al in our report detailing that thyroidectomy is still an effective treatment option for some patients with Graves’ disease and thank them for their in-depth review of our findings. We agree that total thyroidectomy is the preferred approach when surgery is indicated. This is predicated on the fact that it can be performed safely by experienced surgeons. We are also aware of the conflicting views on the prognosis of differentiated thyroid cancer in patients with Graves’ disease. We have no evidence to support a more aggressive course because only 8 of our 48 patients were found to have cancer. Five of these were clinically apparent either by palpation (4 patients) or ultrasound (1 patient). Three patients had an incidental microscopic (≤5 mm diameter) papillary thyroid cancer. All 8 patients are alive with no evidence of their cancer. Seven of our patients received postoperative radioiodine, 5 with a diagnosis of cancer and 2 with a diagnosis of ophthalmopathy. Because most of these patients are referred to us by an endocrinologist, some of the decision making about further radioiodine therapy reverts back to them because they provide ongoing follow-up evaluation and management. Our own approach is to perform a diagnostic radioiodine scan after thyroidectomy for those patients with clinically apparent nodules that harbor a cancer and to perform a treatment dose if there is remaining uptake in the thyroid bed. We agree that incidental cancers do not require radioiodine treatment unless they are multifocal and if thyroid tissue was left overlying the recurrent laryngeal nerve or parathyroid glands to protect them during the dissection. Thyroidectomy remains an effective treatment option for Grave’s diseaseThe American Journal of SurgeryVol. 194Issue 2PreviewWe read with interest the article “Thyroidectomy remains an effective treatment option for Grave’s disease” by Weber et al [1] and we would like to share our experience in a tertiary care referral center. We are in agreement with the authors that surgery has a definite role in the management of a subgroup of patients with Grave’s disease (GD). Subtotal thyroidectomy is thought to be the procedure of choice and total thyroidectomy (TT) is indicated in patients with associated nodules and ophthalmopathy. Full-Text PDF" @default.
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• W4237590436 date "2007-08-01" @default.
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• W4237590436 title "Thyroidectomy remains an effective treatment option for Graves’ disease: reply" @default.
• W4237590436 doi "https://doi.org/10.1016/j.amjsurg.2006.07.021" @default.
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