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: 
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    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.
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    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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