DOI: https://doi.org/10.36347/gamj.2024.v05i03.008

Pages: 79-83

Purpose: To describe the therapeutic aspects of large goiters. Methodology: We conducted a retrospective and prospective study including 115 patients from 2009 to 2014 (6 years). We conducted a retrospective study including 95 patients from January, 2009 till December, 2013 (5 years) and a prospective study including 20 patients from January, 2014 till December, 2014 (1 year) in Central Hospital of University of Point G in Bamako (Mali). Large goiter was defined as any goiter including the height or width was greater than or equal to 10 centimeters (cm). Results: We collected 115 patients. The average age of patients was 44.43 years ±14. 3 with extremes of 9 and 80 years. It was 101 women (87.8%) and 14 men (12.2%) with a sex. ratio of 7.2 in favor of women. The average height of goiter was 12.1 cm ± 3.5 cm with extremes of 10 and 29 cm and the average width was 14.4 cm ± 5.4 cm with extremes of 10 and 32 cm. Thyroid ultrasound of large goiters were multinodular at 100% (111/115). We realized a subtotal thyroidectomy in 73.9% (85/115), an Isthmo - lobectomy in 23.5 (27/115), a total thyroidectomy in 2.6% (3/115). Histology found an adenoma in 97.3% of cases (108/111) and a carcinoma in 2.7% (3/111). The postoperative were simple in 81.7% (94/115), complicated in 18.3% (21/115). The main complications were the dysphonia in 47.7% (10/21), compressive hematoma in14.3% (3/21), dyspnea in 14.3% (3/21), hypothyroidism in14.3% (3/21). Mortality was 0%. Conclusion: Large goiters give anatomical changes of the cervical region that may be responsible for difficulties of the thyroidectomy.