The Study
Extent of Surgery in the Surgical Treatment of Graves' Disease: Subtotal vs. Total Thyroidectomy and Comparison of the Long-term Results
This study looked at what happened to people who had different types of thyroid surgery over many years. It found that people who had their whole thyroid removed were less likely to get sick again, but that doesn't mean the surgery itself caused it—maybe the doctors chose different surgeries for different people for other reasons.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
When doctors remove the whole thyroid gland to treat an overactive thyroid (Graves' disease), the disease almost never comes back. But if they leave a little bit behind, it might come back — especially if they leave 4 grams or more.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 566 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — avoiding recurrence means fewer repeat treatments, less risk of long-term complications, and better quality of life, even if temporary low calcium occurs more often with full removal.
- 20% of patients who had their whole thyroid removed had the disease return.
- 38% of those who had only part removed had it come back.
- 4If more than 4 grams of thyroid tissue was left behind, 17.8% had a return of symptoms.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
The Medical Bulletin of Sisli Etfal Hospital
Year
2024
Authors
B. Sengun, Y. Iscan, I. C. Sormaz, N. Aksakal, G. Yegen, H. Hacisahinogullari, E. Isik, F. Tunca, Y. Senyurek
Related Content
Claims (6)
After partial removal of the thyroid gland in Graves' disease patients, a remaining tissue mass of 4 grams or more is linked to a 17.8% chance of ongoing hyperthyroidism, while remaining tissue under 4 grams is linked to no recurrence.
In patients with Graves' disease, removing the entire thyroid gland results in a higher rate of temporary low calcium levels due to parathyroid injury compared to removing only part of the thyroid, but the rates of permanent low calcium levels and vocal cord paralysis are the same with both procedures.
Patients with Graves' disease who undergo complete removal of the thyroid are more likely to be found to have small, undetected thyroid cancer than those who have only part of the thyroid removed. This difference is due to more thorough examination during complete surgery, not because the surgery causes cancer.
Patients with Graves' disease who undergo complete removal of the thyroid gland have no recurrence of hyperthyroidism, while 8% of those who undergo partial removal experience recurrence.
Patients who had subtotal thyroidectomy were followed for a longer time on average than those who had total thyroidectomy, which could affect how recurrence and complication rates are compared between the two groups.
Thyroid removal is recommended for people with Graves' disease when the enlarged thyroid gland presses on nearby structures or interferes with normal function.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.