Thyroid function after surgery for autonomous and non-autonomous nodular endemic goitre--effect of iodide-substitution

• Published in: Klinische Wochenschrift 1985-09, Vol.63 (17), p.812-820
• Main Authors: Wahl, R A, Joseph, K, Bögner, E, Ohmann, C, Goretzki, P, Röher, H D
• Format: Article
• Language: English
• Subjects: Clinical Trials as Topic; Combined Modality Therapy; Goiter, Endemic - surgery; Goiter, Nodular - surgery; Humans; Iodine - therapeutic use; Postoperative Complications - blood; Recurrence; Thyroid Function Tests; Thyroid Hormones - blood; Thyroidectomy
• ISSN: 0023-2173; 1432-1440
• DOI: 10.1007/BF01732286

The aim of this study was to evaluate the influence of postoperative iodide-substitution on the function of thyroid remnants of different quality and quantity in order to define the appropriate prophylaxis (iodide or thyroid hormone) to prevent recurrent goitre. In a prospective, randomized clinical trial, the following patients were examined: group I: simple, non-autonomous nodular goitre, bilateral thyroidectomy (n = 40); group II: simple, non-autonomous nodular goitre, "selective" (unilateral) thyroidectomy (n = 40); group III: autonomous nodular goitre, bilateral thyroidectomy (n = 40); group IV: autonomous nodular goitre, "selective" (unilateral) thyroidectomy (n = 35). The following parameters were measured 6 and 12 weeks postoperatively. Serum-total-T4, -T3, -TSH, TRH-test, 99mTc-Thyroid-Uptake (TcTU). Six weeks postoperatively the 4 groups were separately randomized into controls and treatment groups, who received 200 micrograms iodide/day orally. Six weeks postoperatively, patients in group I had lower T4 levels and both basal and stimulated TSH were higher than in the other groups, however no significant differences were observed in T3, T4/T3 ratio and TcTU. Twelve weeks postoperatively patients from groups I, II and III, who had been treated with iodide, had lower T3 and TcTU values but higher T4 and T4/T3 than the appropriate controls. Basal and stimulated TSH showed no differences between controls and iodide-treated patients in these groups. In group IV, T4 and T3 showed a tendency to elevation (n.s.), and basal and stimulated TSH as well as TcTU were lower in patients with iodide.