Graves' disease is an autoimmune disorder caused by thyroid stimulating auto-antibodies directed against the thyrotropin receptor on thyroid follicular cells. It is the most common cause of hyperthyroidism and is associated with cardiovascular, ophthalmologic and other systemic manifestations. Three treatment options are available for Graves' disease: anti-thyroid drugs, radioactive iodine and thyroidectomy. While thyroidectomy is the least common option used for treatment of Graves' disease, it is preferentially indicated for patients with a large goiter causing compressive symptoms, suspicious or malignant thyroid nodules or significant ophthalmopathy. The best operation for Graves' disease has been a matter of debate. The standard operation was a subtotal thyroidectomy for much of the twentieth century, however, over the past 20 years total thyroidectomy has been increasingly performed. Herein, we provide a historical perspective and review the current literature, including randomized controlled trials, systematic reviews and meta-analyses and conclude 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.

中文翻译：

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治疗Graves病和适当程度的甲状腺切除术的患者。

Graves病是一种由甲状腺刺激的针对甲状腺滤泡细胞上促甲状腺激素受体的自身抗体引起的自身免疫性疾病。它是甲状腺机能亢进的最常见原因，并与心血管，眼科和其他全身表现有关。格雷夫斯病有三种治疗选择：抗甲状腺药物，放射性碘和甲状腺切除术。尽管甲状腺切除术是用于治疗格雷夫斯病的最不常见的选择，但优先用于甲状腺肿大，引起压迫症状，可疑或恶性甲状腺结节或严重眼病的患者。格雷夫斯病的最佳手术一直存在争议。在20世纪的大部分时间里，标准手术是甲状腺大部切除术，在过去的20年中，全甲状腺切除术越来越多。在此，我们提供了历史观点并回顾了当前的文献，包括随机对照试验，系统评价和荟萃分析，并得出结论，全甲状腺切除术是Graves病外科治疗的首选方案，复发率接近0％，可预测的术后甲状腺功能减退症和低并发症发生率，与由甲状腺大手术医生进行的甲状腺亚次全切除术相当。