MON-374 Influence of Preoperative Thyroid Status on Clinical Outcomes in Graves' Disease Undergoing Thyroidectomy

Abstract Disclosure: P. Lee: None. P. Chen: None. H. Chen: None. C. Huang: None. Background: A euthyroid state before thyroidectomy is recommended by guidelines to minimize surgical complications. Nevertheless, it is not always achievable due to drug intolerance, refractory disease, or surgical urgency. This study explores the impact of preoperative thyroid status on surgical outcomes, particularly thyrotoxicosis at the time of surgery. Method: This retrospective study analyzed patients with Graves’ disease who underwent thyroidectomy at Taipei Veterans General Hospital, Taiwan, between 2019 and 2023. Data on patient demographics, thyroid function, comorbidities, biochemical parameters, perioperative and postoperative complications, and length of hospital stay were retrieved from the medical records. Surgical outcomes were compared between the preoperative thyrotoxic versus the euthyroid group. Results: A total of 81 patients (79% female) with a mean age of 45.1 ± 12.2 years were analyzed. Among them, 33.3% (n=27) were thyrotoxic preoperatively. Compared to the euthyroid patients, the thyrotoxic group had lower TSH levels, higher TSH receptor antibody titers and higher ALT levels, more frequently received Lugol’s solution, lithium, and hydrocortisone preoperatively. Surgical outcomes, including hypocalcemia, hoarseness, intraoperative blood loss, and operation time, were comparable between the two groups, with no cases complicated by thyroid storm or mortality. Length of total hospital stay were not significantly different between the two groups, but the length of postoperative stay was longer in the thyrotoxic group (6.4 ± 5.2 days vs. 5.4 ± 5.1 days, P= 0.043). Conclusion: Thyroidectomy can be safely performed in patients with Graves’ disease with preoperative thyrotoxicosis under optimal preparation, suggesting that achieving a euthyroid state may not always be necessary before surgery. Funding: This research was partially supported by funding from the National Science and Technology Council, Taiwan (NSTC 112-2314-B-075-025 to CJH and NSTC112-2314-B-A49-081 to HSC) and the Taipei Veterans General Hospital-National Taiwan University Hospital Joint Research Program (VN113-14) to CJH. Presentation: Monday, July 14, 2025