Hyperthyroidism Anatomical and Clinical Aspects and Surgical Management at the IGNACE DEEN University Hospital in Conakry

Abstract

Introduction: Hyperthyroidism corresponds to a dysfunction of the thyroid gland, which secretes hormones in excessive quantities on the one hand and on the other hand clinical and/or biological manifestations of thyrotoxicosis. The objective of our study was to evaluate, through a retrospective study, the anatomical-clinical aspects and the surgical management of hyperthyroidism in the general surgery department of the Ignace Deen national hospital. Material and method: This was a retrospective study of descriptive type with a duration of 5 years from January 1, 2013 to December 31, 2017. This study included all the records of patients admitted to the general surgery department of the Ignace Deen hospital with the diagnosis of hyperthyroidism with biological confirmation during the study period. The diagnosis of hyperthyroidism was evoked in front of clinical signs of thyrotoxicosis and confirmed by the collapse of the thyroid stimulating hormone (TSH) below 0.25 mUI/L and elevation of free T4 higher than 22 pmol/L. Results: During this study period, we collected 6210 patient files, among which 133 cases of hyperthyroidism, i.e. 2.14% of the total number of pathologies received in the department. Predominance of women and an average age of 39.73. Among the signs of compression recorded, dyspnea was the most frequent, followed by dysphagia and dysphonia. We noted abnormalities of tracheal deviation and/or compression on cervical radiography in our study. We had mostly heteromultinodullary goiter, followed by diffuse goiter and basedow disease. Subtotal thyroidectomy was the most used surgical procedure with 69.1% followed by loboisthmectomy with 29.3% and finally total thyroidectomy with 1.5%. Conclusion: In our practice, subtotal thyroidectomy gave good results with an acceptable rate of hypothyroidism and no recurrence of hyperthyroidism in the short term. Radioactive iodine therapy remains a challenge in our context.