Thyroidectomy at El Obeid Hospital, Western Sudan.

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El Bushra Ahmed Doumi
Mohamed Ibrahim Mohamed
Awadalla Musa Abakar
Mohamed Yousif Bakhiet

Abstract

AbstractAbstractBackground: Enlargement of the thyroid gland is an endemic health problem in Western Sudan and thyroidectomy is often performed in hospitals with different surgical approach for various reasons.Objectives: To study the indications, types, complications and outcome of thyroidectomy at El Obeid Hospital, Western Sudan.Patients and Methods: This is a retrospective descriptive study. The medical records of patients who underwent thyroidectomy during 2000 to 2007 at the University Surgical Unit, in El Obeid Teaching Hospital were reviewed. The data were analyzed for gender, age, clinical diagnosis, indications, type of operations performed and treatment outcomes.Results: There were 216 females and 30 males. 74.8% were between 21 and 50 years old. 60.2% of the operations were for endemic multinodular goitre mainly for pressure symptoms or signs, 14.6% for solitarythyroid nodules, 13% for simple diffused goitre, 6.5% for toxic goitre, and 5.7% for cancer. Near-total thyroidectomy was performed in 75.6% of cases, total thyroidectomy in 11.4%, unilateral lobectomy plusisthmus in 11% and nodulectomy in 2%. 36 patients needed blood transfusion, drains were inserted in allpatients and 3 patients had tracheotomies. The mortality rate was 2%. Conclusion: Thyroidectomy was a common operation at El Obeid Hospital. Near-total thyroidectomy was performed for benign goitre, whereas total thyroidectomy was done for cancer. Both procedures were effective and relatively safe within the current hospital setup. A more effective method for long term follow up isneeded. More surgical training and provision of intensive postoperative care facilities must precede adoptionof more radical approach for benign lesions as recommended elsewhere.

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References

Reference
1. Eltom MA. Endemic goitre in the Sudan. Doctoral
Thesis. Uppsala, Sweden: Uppsala University,
1984.
2. Gardiner KR, Russell CFJ. Thyroidectomy for
large multinodular goiter. J. R. Coll. Edinb. 1995;
40: 367-70.
3. Mattioli FP, Torre GC, Borgonovo G, Arezzo A,
Amato A, De Negri A, et al. Surgical treatment
of multinodular goiter. Ann Ital Chir. 1996; 67:
341-5.
4. Bakheit MA, Mahadi SI, Ahmed ME. Indications
and outcome of thyroid gland surgery in Khartoum
Teaching Hospital. Khartoum Medical Journal.
2008; 1: 34-37.
5. Al-Hureibi KA, Abdulmughni YA, Al-Hureibi MA,
Al-Hureibi YA, Ghafoor MA. The epidemiology,
pathology and management of goitre in Yemen.
Ann Saudi Med. 2004; 24: 119-23.
6. Hill AG, Mwangi I, Wagana L. Thyroid disease in
a rural Kenya hospital. East Afr Med J. 2004; 81:
631-3.
7. Soyannwo OA, Ajao OG, Agbejule OA, AmanorBoadu
SD. Anaesthesia and surgical aspects of
thyroid swelling: the Ibadan experience. East Afr
Med J. 1995; 72: 675-77.
8. Shima K, Joseph G. Coping with respiratory
obstruction after thyroidectomy for giant goitres
in Northern Nigeria. Ann Roy Coll Surg Engl.
1988; 70: 99-104.
9. Ahmed ME, Elgizouli S, Suliman SH, et al. The
solitary thyroid nodule in Khartoum. Sud Med J.
1996; 34: 13-16.
10. Al-Tameem MM. Lobectomy for Solitary Thyroid
Nodules. Saudi Med J. 1989; 10: 249-253.
11. Wagana LN, Mwangi I, Bird P, Hill AG.
Management of solitary thyroid nodules in rural
Africa. East Afr Med J. 2000; 79: 584-87.
12. Ahmed ME, El Wasila AA, Sanhouri M, Yagi K.
Surgical management of toxic goiter in Khartoum.
Trop Geogr Med. 1993; 45: 124-5.
13. Torre G, Borgonovo G, Arezzo A, Costantini M, et
al. Is euthyroidisim the goal of surgical treatment
of diffuse toxic goiter? Eur J Surg. 1998; 164:
495-500.
14. Delbridge L, Guinea AI, Reeve TS. Total
thyroidectomy for bilateral benign multinodular
goiter, effect of changing practice. Archives of
Surgery. 1999; 134: 1389-93.
15. Guraya SY, Eltinay OA. Total thyroidectomy for
Bilateral Benign Thyroid Disease: Safety Profile
and Therapeutic Efficacy. Kuwait Med J. 2007;
39: 149-152.
16. Friguglietti CU, Lin CS, Kulcsar MA. Total
Thyroidectomy for benign thyroid disease.
Laryngoscope. 2003; 113: 1820-26.
17. Bellantone R, Lombardi CP, Bossola M, et al.
Total thyroidectomy for management of benign
thyroid disease: review of 526 cases. World J
Surg. 2002; 26: 1468-71.
18. Muller PE, Schmid T, Spelsberg F. Total
thyroidectomy in iodine-deficient goiter: an
effective treatment alternative? Zentralbl Chir.
1998; 123: 39-41.
19. Thomusch O, Sekulla C, Dralle H. Is primary total
thyroidectomy justified in benign multinodular
goiter? Results of a prospective quality assurance
study of 45 hospitals offering different levels of
care. Chirurg. 2003; 74: 437-43.
20. Siragusa G, Lanzara P, Di Pace G. Subtotal
thyroidectomy or total thyroidectomy in the
treatment of benign thyroid disease. Our
experience. Minerva Chir. 1998; 53: 233-38.
21. Acun Z, Comert M, Cihan A, Ulukent SC, Ucan B,
Cakmak GK. Near-total thyroidectomy could be
the best treatment for thyroid disease in endemic
regions. Arch Surg. 2004; 139: 444-47.
22. Sedov VM, Sedletskii I, Belianina EO. Surgical
treatment of recurrent goiter. Vestn Khir Im II
Grek. 1999; 158: 53-56.
23. Seiler CA, Glaser C, Wagner HE. Thyroid gland
surgery in an endemic region. World J Surg.
2004; 20: 593-97.
24. Ibis E, Erbay G, Aras G, Akin A. Postoperative
goitre recurrence rate in Turkey. Acta
Endocrinologica. 1991; 125: 33-37.