What Is the Best Definitive Treatment for Graves’ Disease? A Systematic Review of the Existing Literature

@article{Genovese2012WhatIT,
  title={What Is the Best Definitive Treatment for Graves’ Disease? A Systematic Review of the Existing Literature},
  author={Bradley Genovese and Salem I Noureldine and Elizabeth Gleeson and Ralph Patrick Tufano and Emad Kandil},
  journal={Annals of Surgical Oncology},
  year={2012},
  volume={20},
  pages={660-667}
}
BackgroundThe management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists for Graves’ disease (GD) include any of the following modalities: 131I therapy, antithyroid medication, or thyroidectomy. No in-depth analysis has been performed comparing the treatment options, even though a single treatment option seems to be universally accepted.MethodsA systematic review of the literature was performed to examine contemporary literature between 2001… 
Revisiting the role of surgery in the treatment of Graves' disease.
TLDR
Possible reasons for the low proportion of surgery in the treatment of Graves' disease are discussed, emphasizing an evidence-based approach to the clinicians' preferences for surgical referrals, surgical indications and confronting traditional reasons and concerns relating to the low referral rate with up-to-date data.
Treatment of patients with Graves' disease and the appropriate extent of thyroidectomy.
TLDR
It is concluded that total thyroidectomy is the preferred option for the surgical treatment of Graves' disease, with a nearly 0% recurrence rate, predictable postoperative hypothyroidism and a low complication rate comparable to subtotal thyroidectomy when performed by high-volume thyroid surgeons.
Use of Adjunctive Therapy to Achieve Preoperative Euthyroidism in Graves’ Disease: A Case Report
TLDR
This case is reported to show that SSKI can be used as adjunctive therapy to achieve a preoperative euthyroid state in refractory Graves’ disease.
Thyroidectomy in Patients with Graves’ Disease
TLDR
Thyroid surgery is one of the principle methods of treatment for Graves’ disease, as well as hyperthyroidism arising from other causes, including toxic adenoma and toxic multinodular goiter, and has clear absolute and relative indications compared to antithyroid medications and radioactive iodine for a subset of patients.
Preoperative management in patients with Graves' disease.
Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the
Management of Graves Thyroidal and Extrathyroidal Disease: An Update
  • G. Kahaly
  • Medicine
    The Journal of clinical endocrinology and metabolism
  • 2020
TLDR
A clear trend towards serological diagnosis and medical treatment of GD has emerged and systemic steroid treatment should be postponed during COVID-19 while local treatment and preventive measures are offered.
Value of total thyroidectomy for Graves' disease in eliminating the risk of recurrence and malignancy: retrospective database analysis of 574 Saudi Arabian patients in 10 years with 2 years follow up
TLDR
It is concluded that total thyroidectomy is a safe and effective treatment modality for Graves' disease that offers rapid and long-lasting results, in addition to eliminating the risk of recurrence and malignancy.
Thyroid surgery for treatment of Graves’ disease complicated by ophthalmopathy: a comprehensive review
TLDR
The effects of thyroidectomy on Graves’ ophthalmopathy development and progression is focused on, and current published data regarding thyroidectomy as a treatment for GD is reviewed.
Short-Term Outcomes of Surgery for Graves’ Disease in Germany
TLDR
Evaluating the current extent of surgery for the treatment of Graves’ disease and its safety as a short-term outcome revealed total thyroidectomy with IONM is safe and currently the most common surgical therapy for GD in Germany.
Diagnosis and management of Graves disease: a global overview
TLDR
Measurements of serum levels of TRAb and thyroid ultrasonography represent the most important diagnostic tests for Graves disease, and novel agents that might act on the disease process are currently under evaluation in preclinical or clinical studies, but evidence of their efficacy and safety is lacking.
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Should total thyroidectomy become the preferred procedure for surgical management of Graves' disease?
TLDR
Total or near-total thyroidectomy obviates these disadvantages and can be performed without increased complication rates, thus appearing to be the preferred extent of thyroidectomy for Graves' disease.
Surgical Treatment of Graves’ Disease: Evidence-Based Approach
TLDR
If surgery is considered for definitive management, evidence-based criteria support total thyroidectomy as the surgical technique of choice for GD and available evidence also supports surgery in the presence of severe endocrine GO.
Role of surgery in the management of Graves' disease.
TLDR
Thyroidectomy has reasonable role in the management of Graves' disease, because the patients have had their diseases rapidly terminated, been hospitalised for an average period of only 3.5 days and have had no permanent functional insult except for hypothyroidism.
Could total thyroidectomy become the standard treatment for Graves’ disease?
TLDR
Removal of all thyroid tissue offers the best chance of preventing recurrent hyperthyroidism and is the most effective surgery for achieving the goal of treatment of Graves’ disease.
Total thyroidectomy: a safe and effective treatment for Graves' disease.
TLDR
Thyroidectomy for patients with Graves' disease can be performed with very low complication rates and when a total thyroidectomy is performed, there is almost no risk of recurrence.
Total Thyroidectomy Is Superior to Subtotal Thyroidectomy for Management of Graves’ Disease in the United States
TLDR
It is felt that TT is safe and superior to ST for management of Graves’ disease in the United States, and there was no recurrences and no increase in postoperative complications in the TT group.
Surgery versus radioiodine therapy as definitive management for graves' disease: the role of patient preference.
TLDR
There is a high level of satisfaction with the decision for surgery as definitive management of Graves' disease with 88% of respondents giving a satisfaction score of 7 or greater on a visual analog scale (VAS) (0-10).
The efficacy of thyroidectomy for Graves' disease: A meta-analysis.
TLDR
Overall, thyroidectomy successfully treated hyperthyroidism in 92% of patients with Graves' disease and there was no significant difference in complication rates between TT and ST.
Treatment of Graves' hyperthyroidism--prognostic factors for outcome.
TLDR
In patients with Graves' hyperthyroidism, radioiodine treatment is associated with higher success rate than antithyroid drugs, and a dose of 13-15 mCi (481-555 MBq) seems to be practical and effective, and should be considered as first line therapy.
Extensive thyroidectomy in Graves' disease.
TLDR
Total or near-total thyroidectomy is an effective and safe treatment for Graves' disease when performed by an experienced surgeon and in the multivariable model these two factors remained independent.
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