Department of Surgery, Jammu & Kashmir, UT, India

Background For individuals having thyroidectomies as part of the therapy of Graves' disease, the American Thyroid Association (ATA) has developed special preoperative preparational instructions. Our objective is to ascertain whether adhering to these recommendations is related with improved results. Methods Between August 2007 and May 2015, 228 individuals with Graves disease who underwent complete thyroidectomy were identified by a retrospective analysis of a prospectively maintained database. Patients who received care in accordance with ATA standards were contrasted with those who did not follow the current preparation guidelines completely. Results 52% of all patients followed ATA recommendations during surgery. Less occurrences of intraoperative tachycardia occurred in patients who were prepared in accordance with ATA standards (0.3 versus 4.5, P = 0.04).but had the same number of episodes of systolic blood pressure > 180 mmHg or peak systolic blood pressure. The mean operating room time and length of stay for ATA prepped and nonprepped patients were comparable. Patients who underwent ATA preparation compared favourably with those who did not, with similar rates of complications such as transient hypocalcemia (30.4% versus 25.5%, P = 0.45), prolonged hypoparathyroidism (0.98% versus 4.3%, P = 0.15), hoarseness (10.8% versus 7.5%, P = 0.42), permanent recurrent laryngeal nerve paralysis (2.9% versus 2.1%, P = 0.71), and hematoma (2. Conclusions According to our findings, following the ATA recommendations for thyroidectomy preparation is not necessary for a favourable surgical outcome. The frequency of intraoperative tachycardia was reduced by following the guidelines, but intraoperative hypertension, operating room time, or postoperative problems were unaffected.

Mohith Sharma. Evaluation of the Total Thyroidectomy in Graves' Disease American Thyroid Association Guidelines. Insights Journal of Surgery and Clinical Case Reports 2019.