Thyroidectomy for Graves’ hyperthyroidism Retrospective study of patients’ appreciation

Abstract

AIM OF THE STUDY: To retrospectively investigate the patients’ views of surgical treatment of Graves’ hyperthyroidism.

METHODS: One hundred two patients were included in the study and submitted to extensive subtotal thyroidectomy or total thyroidectomy between 1993-2003. Data were acquired from the responses to a questionnaire, that was completed by 83 patients.

RESULTS: Before the operation the working/studying ability and the social/emotional relations were impaired in 20% and 22% of cases. Preoperative information was adequate for 84% of patients. The perception of the hospital efficiency was favourable in 89% of cases, and the interpersonal relations with clinicians and nurses were very positive for 96% of patients. After the operation, all patients were hypothyroid on levothyroxine (l-T4); unexpected problems with l-T4 therapy occurred in 6% of cases. Voice changes or neck discomfort were reported by 29% and 8% of patients. The aesthetic appearance of the scar was very satisfactory for 70% of patients, but 11% were unsatisfied. The working/studying ability and the social/emotional relations improved in 63% and 59% of cases. Eye symptoms improved in 71% of the patients with endocrine ophthalmopathy, but got worse in 6%. The quality of life, expressed with a 0 to 10 scale, improved from a mean preoperative score of 4.7 to a mean score of 7.9 (P=0.000). Only 5% of patients expressed hesitation to recommend surgery to a friend with similar disease.

CONCLUSIONS: Surgery is an effective therapy for selected cases of Graves’ disease and meets the expectations of the majority of patients. Nevertheless some possible factors for dissatisfaction are pointed out.