EP137 – Thyroid surgery in Tanzania: experience of a surgical help program

     

    Alqahtani, Shareef1; Akkad, Mohammed1; Mbabali, Joseph2; Mahmoud, Ali3
    1 Surgery Department, King Fahad Specialist Hospital- Dammam, Saudi Arabia
    2 Department of Surgery, Zanzibar University, Tanzania
    3 Department of Surgery, University of Khartoum, Sudan

     

    Introduction: Iodine deficiency is the most common thyroid disorder in Tanzania. This study demonstrated our experience as a surgical help group to provide thyroid surgical management.

    Methods: A prospective observational analysis of 68 thyroid surgical procedures during several visits between January 2013 and October 2016 in four regions in Tanzania.

    Results: We performed surgical thyroid treatment for 68 patients with grade II or III goiter according to WHO classification. Hemithyroidectomy was performed for unilateral disease in 41 patients, Subtotal thyroidectomy for 21 patients, and six-patients had total thyroidectomy. The main complications were a single unilateral recurrent laryngeal nerve injury, and post-operative hematoma in two patients. Histological examination revealed multinodular goiter was the most common (48 patient), followed by Grave’s disease (13 patients), and cancer was found in seven-patients.

    Conclusions: Total thyroidectomy can be performed in limited resources countries safely with low complication rates. Avoiding total thyroidectomy is preferred when access to hormonal replacement or follow up cannot be guaranteed.

     

    References: 

    1. Andersson M, Takkouche B, Egli I et al (2005) Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. Bull World Health Organ 83:518–825.
    2. Baxi M, Shetty KJ, Baxi J et al (2006) Need for an individualized and aggressive management of multinodular goiters of endemic zones by specially trained surgeons: experience in Western Nepal. World J Surg 30:2101–2109.
    3. Nmadu PT, Mabognje OA (1991) The risk of cancer in endemic goitre. Cent Afr J Med 37:242–244.
    4. Watters DAK, Wall J (2007) Thyroid surgery in the tropics. ANZ J Surg 77:933–940
    5. Watters DAK, Benn C, Echun DA et al (1991) Audit of “surgery in general” in an African Teaching Hospital. J R Coll Surg Edinb 36:402–404.
    6. Zambudio AR, Rodriguez J, Riquelme J et al (2004) Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann Surg 240:18–25

 

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