Surgical management of Graves' disease: historical context and single institution experience.

Aim: To describe indications and outcomes of total thyroidectomy for Graves' disease in a large New Zealand endocrine surgery unit, and to compare these results to international studies.

Methods: We analysed a prospectively collected database to describe the indications and outcomes of surgery for Graves' disease between December 2001 and January 2021.

Results: Among 64 patients who underwent total thyroidectomy at our tertiary centre for Graves' hyperthyroidism, Graves' ophthalmopathy and patient preference/aversion to radioactive iodine were the most common indications for surgery. Total thyroidectomy resulted in long-term control of thyrotoxicosis in all patients. There were no incidences of recurrent laryngeal nerve injury. One patient (1.6%) suffered permanent hypoparathyroidism.

Conclusion: Total thyroidectomy is a safe and effective treatment for Graves' disease. In our population, total thyroidectomy functions as a second-line treatment for Graves' disease.