alexa Patterns and outcome of surgical management of goitres at Bugando Medical Centre in northwestern Tanzania
Anesthesiology

Anesthesiology

Journal of Anesthesia & Clinical Research

Author(s): Phillipo L Chalya, Peter Rambau, Joseph B Mabula, Emmanuel S Kanumba, Godfrey Giiti

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Despite the well established endemicity of goitres little work has been done on the management of goiters in Tanzania . A cross - sectional study was conducted at Bugando Medical Centre (BMC) in Mwanza, Tanzania to determine the pattern and outcome of surgical management of goitres. Data was collected using a pre - tested, coded questionnaire. A total of 152 patients were studied of which 140 (92.1%) were females and males were 12 (7.9%) (F: M = 11.7: 1). Their ages ranged from 18 to 72 years (mean =38.4  12.5 years). The mean duration of illness was 9.2 years. The thyroid gland size at admission was grade III in 63.8% of patients. Multinodular goitres were reported in 51.3% of patients. The majority of patients ( 92.1%) presented wi th euthyroi d goitres and the remaining (7.9%) patients had toxic goitres. Pressure symptoms and cosmetic disfigu rement were the common indications for thyroidectomy in 47.4% and 23.7% , respectively. Near total thyroidectomy and total thyroidectomy were the surgical procedures performed for benign and malignant goitres in 47.3% and 8.1 % of patients , respectively. Simple m ultinodular goitres were the most common histo patho logical pattern accounting for 67.2% of cases. Twelve (7.9%) patients had a histological ly proven thyroid malignancy, of which follicular and papillary carcinoma were reported in 41.7% and 33.3% of cases , respectively . Post - operative complications rate was 7.9%. The mean length of hospital stay was 14 .4 days (range 3 to 3 4 days). Five patient s die d giving a mort ality rate of 3.4 % . In conclusion, this study has shown that the pattern of surgical goitres seen at Bugando Medical Centre is similar to what is reported from other parts of the world. However, t he majority of patients present for surg ery very late with huge goitres predisposing them to increased risk of post - operative complications, prolonged length of hospital stay and cost of medical care. It is therefore recommended that health education should be given to the community about the ca use , prevention and treatment options so that patients could seek early medical attention.

This article was published in Tanzania Journal of Health Research and referenced in Journal of Anesthesia & Clinical Research

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