Short-term outcomes of thyroid surgery at a regional referral hospital in Ruhengeri, northwest Rwanda: A 1-year retrospective study

Abstract

Background

In the rural areas of sub-Saharan Africa, goitres are often undertreated due to the limited availability of thyroid surgery in referral hospitals. This study evaluated patient outcomes following surgical treatment for goitres at Ruhengeri Referral Hospital, a re­source-limited hospital in northwest Rwanda.

Methods

We reviewed the medical records of patients who were surgically treated for goitres between December 2017 and November 2018. Data were collected on the following variables: patient sex, patient age, date of symptom onset, clinical diagnosis, indication for surgery, laboratory findings, fine needle aspiration findings, imaging findings, surgical procedure, anaesthetic review details, postoperative complications, length of hospital stay, and follow-up findings.

Results

Our analysis included 44 of the 48 patients who underwent thyroid surgery during the investigated period. Four patients who did not have postoperative follow-up visits were excluded from the analysis. The median patient age was 46 years (range, 18-77 years); 42 patients (95.5%) were women, and 2 patients (4.5%) were men. The most common indication for thyroidectomy was multi­nodular goitre (n=32, 72.7%), causing either pressure symptoms or cosmetic concerns. The most common surgical procedure conducted was subtotal thyroidectomy (n=34, 77.3%), followed by lobectomy (n=6, 13.6%). Two patients (4.5%) who presented with clinical features suggestive of Graves’ disease underwent total thyroidectomy. The average length of hospital stay was 24 hours. No postoperative complications were observed or reported in patients during their hospitalizations or the during the 2 weeks following hospital discharge.

Conclusions

A sizeable number of surgical procedures for goitre were conducted at Ruhengeri Referral Hospital, Rwanda. The absence of short-term postoperative complications suggests that thyroid surgery can be conducted safely in hospitals with limited resources if medical doctors have adequate surgical skills and if patient selection and preparation are properly undertaken.