Thyroid surgery at a volunteer program in Sub-Saharan Africa

Area of Science:

• Surgical Oncology
• Endocrinology
• Global Health

Background:

• International thyroid surgery guidelines are challenging to implement in resource-limited areas due to lack of preoperative testing and hormone replacement therapy.
• Volunteer surgical programs offer a vital solution for addressing surgical needs in underserved regions.

Purpose of the Study:

• To present the experience of a volunteer surgical program performing thyroidectomies in Cameroon.
• To evaluate the safety and feasibility of adapted thyroid surgery techniques in a low-resource environment.

Main Methods:

• A prospective observational study of 16 thyroid surgery cases in Dschang, Cameroon (June 2015).
• Patients were pre-selected by a local medical team.
• Surgical techniques included hemithyroidectomy with isthmectomy for unilateral disease and bilateral subtotal thyroidectomy for bilateral disease.

Main Results:

• 16 procedures performed: 5 subtotal thyroidectomies, 9 hemithyroidectomies, and 2 isthmectomies.
• High visualization rates for parathyroid glands (86%) and recurrent laryngeal nerves (84%).
• Low complication rate: 1 cervical hematoma requiring reoperation, 2 surgical wound infections; no hypocalcemia or nerve lesions.

Conclusions:

• Thyroid surgery can be safely performed in developing countries by adapting protocols, such as avoiding total thyroidectomy.
• Bilateral thyroidectomies require careful consideration, necessitating follow-up functional studies and guaranteed hormone supplement availability.