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Fifty-one patients with Graves' disease were operated on Yamada Red Cross Hospital. Total thyroidectomy was performed in 21 patients, and subtotal thyroidectomy in 30 patients. In our hospital, subtotal thyroidectomy is different from the conventional subtotal thyroidectomy, with total resection of the unilateral lobe with subtotal resection of the contralateral lobe. This procedure is a modified technique of Hurtly-Dunhil's operation. Bilateral recurrent laryngeal nerves are exposed as far as the orifice into the larynx, and parathyroid glands are preserved as far as possible. From two to four grams of the thyroid is a preferred residual volume. The residual volume was under 2 grams in 5 patients, 2 4 grams in 19 patients, 4 6 grams in 5 patients, and over 6 grams in 1 parient. Postoperatively, there was normalized thyroid function in 13 patients and hypothyroidism in 16 patients who underwent subtotal thyroidectomy. Recurrence of hyperthyroidism was observed in only one patient, who was reoperated safely and postoperative complications were not observed. In 51 patients operated on our hospital, recurrent laryngeal nerve paresis was not observed in all cases. Postoperative hypoparathyroidism was observed in 2 cases. In view of postoperative thyroid function and safe reoperation, our procedure for subtotal thyroidectomy is valuable.
特定非営利活動法人日本頭頸部外科学会の論文