Total thyroidectomy: A viable option in the management of hyperthyroidism in a resource constrained setting

Abstract

Objective: Although total thyroidectomy was initially thought to be fraught with complications, adequate training and exposure ensure the safety of this procedure which is beneficial in areas where patients’ access to good surgical and follow-up care is limited This study aims to describe our experience with total thyroidectomy as the treatment of hyperthyroidism as well as the clinical outcome in the University College Hospital (UCH), Ibadan, Nigeria.

Design: This is a retrospective study. Setting and Subjects: This is a review of the records of all patients who had total thyroidectomy for variable forms of toxic goiters in the Endocrine Surgery Division of UCH, Ibadan, Nigeria between January 2001 and December 2015. Intervention: All the patients who had Graves’ disease, toxic multinodular goiter, toxic solitary adenoma had total thyroidectomy.

Outcome: Reviewed outcomes were mean hospital stay and the incidence of postoperative complications.

Results: 652 total thyroidectomies were performed for different pathologies of the thyroid gland. Of these, 149 (22.8%) were for cases of hyperthyroidism consisting of male 16 (15.9%) and female 133 (84.1%). The median hospital stay was for 4 days (range 3-11 days). There was no permanent recurrent laryngeal nerve injury. Nine patients developed variable forms of hypocalcaemia. Only 1.3% of our patients required a perioperative tracheostomy.

Conclusion: We recommend total thyroidectomy to be the first option in the surgical management of patients who have hyperthyroidism