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Surgery, at the present time, gives a higher percentage of cures than any other measure in the treatment of exophthalmic goiter. For a number of years the mortality following surgical procedures has gradually decreased, largely because much has been learned regarding the selection of the type of operation which is safest in any given case, and because the greater number of patients are operated on earlier in the course of the disease than formerly, and at a time when they are better surgical risks. It is possible to operate by present day methods in a large number of consecutive cases of exophthalmic goiter without a death. There are, however, a few patients who fail to respond to preoperative medical treatment and who must be subjected to operation at a relatively high risk, in order to offer a chance for cure. Refusal to operate in this group of cases naturally diminishes
SISTRUNK WE. THE SELECTION OF OPERATION FOR EXOPHTHALMIC GOITER. JAMA. 1920;74(5):306-308. doi:10.1001/jama.1920.02620050014005