Citations 2
Revisiting the role of surgery in the treatment of Graves’ disease
Cohen, Oded , Ronen, Ohad , Khafif, Avi, Rodrigo, Juan P. , Simó, Ricard , Pace‐Asciak, Pia , Mikkelsen, Lauge Hjorth , Kowalski, Luiz Paulo , Olsen, Kerry D., Sanabria, Álvaro , Babighian, Silvia , Shaha, Ashok R. , Zafereo, Mark , Ferlito, Alfio , Sanabria, Alvaro , Rodrigo, Juan P , Kowalski, Luiz P , Randolph, Gregory William , Tufano, Ralph Patrick
Clinical Endocrinology | December 26, 2021 | Volume: 96 | Issue: 6 | Pages: 747-757
AbstractGraves’ disease (GD) can be managed by antithyroid drugs (ATD), radioactive iodine (RAI) and surgery. Thyroidectomy offers the highest success rates for both primary and persistent disease, yet it is the least recommended or utilized option reaching <1% for primary disease and <25% for persistent disease. Several surveys have found surgery to be the least recommended by endocrinologists worldwide. With the development of remote access thyroidectomies and intraoperative nerve monitoring of the recurrent laryngeal nerve, combined with current knowledge of possible risks associated with RAI or failure of ATDs, revaluation of the benefit to harm ratio of surgery in the treatment of GD is warranted. The aim of this review is to discuss possible reasons for the low proportion of surgery in the treatment of GD, 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.
Case for staged thyroidectomy
Ronen, Ohad , Robbins, K. Thomas , Olsen, Kerry D., Shaha, Ashok R. , Nixon, Iain J. , Zafereo, Mark , Hartl, Dana M. , Kowalski, Luiz Paulo , Rodrigo, Juan P. , Coca‐Pelaz, Andrés , Poorten, Vincent Vander , Sanabria, Álvaro , Rinaldo, Alessandra , Ferlito, Alfio , Kowalski, Luiz P , Rodrigo, Juan P , Coca-Pelaz, Andrés , Vander Poorten, Vincent , Sanabria, Alvaro , Randolph, Gregory William , Mäkitie, Antti , Angelos, Peter
Head & Neck | August 6, 2020 | Volume: 42 | Issue: 10 | Pages: 3061-3071
AbstractRecent modifications in the management of well‐differentiated thyroid cancer have resulted in significant alterations in clinical approach. Utilizing a series of preoperative and postoperative risk factors involving both the patient and the disease pathology, we offer the term “staged thyroidectomy” to help organize these risk factors for patients and the endocrine team to optimize management. This approach is intended to incorporate our latest nuanced understanding of certain endocrine pathology and may serve to optimize patient outcomes.