Operative management of thyroid disorders in Maiduguri.

Abstract

BACKGROUND: Goiters are a common problem worldwide and its operative treatment has evolved over the years to become one of the safest operations in general surgery. The objective of this study is to evaluate the outcome after thyroidectomy for the treatment of goiters. METHOD: A retrospective study of all patients undergoing thyroid surgery at the University of Maiduguri Teaching Hospital (UMTH) over a five year period (January 2000 to December 2004) was conducted, to establish the pattern of the disease and the outcome of management. RESULTS: A total of 184 thyroid operations were performed during the study period. This comprised 163 (88.6%) females and 21 (11.4%) males. The mean age was 33.9 +/- 11.3 years (range 12-65). The male, female ratio was 1:7.8. One hundred and seventy four (94.6%) of the patients had benign thyroid disease, and 10 (5.4%) had thyroid carcinoma. All the patients presented with anterior neck swelling and this was the only complaint in 107 (58.1%) of the patients. The mean duration of symptoms was 6.61 +/- 7.1 years, (range 3 months - 40 yrs). The indications for operation were cosmesis in 88 (47.8%), toxic symptoms in 64 (34.8%), pressure symptoms in 16 (8.7%), suspicion of malignancy in 13(7.1%) and recurrent goiter in 3(1.6%). The most frequent operative procedure was subtotal thyroidectomy in 143(77.7%) patients. Postoperative complications included seroma of the surgical site in 24 (13.0%), wound infection in 12 (6.5%), airway obstruction due to haematoma in 12 (6.5%) and hypoparathyroidism in 11(5.9%) of the patients. The mean duration of hospital stay was 8.8 +/- 4.4 days (4-28). There was one case of recurrent laryngeal nerve injury. There was no mortality following thyroidectomy. CONCLUSION: Thyroidectomy is a very safe operation, with no mortality and extremely low morbidity rate. Majority of thyroid disorders in this environment were benign and subtotal thyroidectomy was sufficient operative management, with low rates of recurrence.