Thyroid Surgery in a Resource-Limited Setting

Area of Science:

• Global Surgery
• Health Outcomes Research
• Endocrine Surgery

Background:

• Conducting long-term outcomes research in resource-limited settings presents unique challenges.
• Humanitarian surgical missions require data on long-term patient outcomes and quality of life.
• Evaluating surgical feasibility and impact in diverse healthcare environments is crucial.

Purpose of the Study:

• To assess the feasibility of long-term (>1 year) outcomes research for thyroid surgery in Eldoret, Kenya.
• To evaluate the impact of thyroid surgery on patient quality of life in a resource-limited setting.
• To inform future humanitarian collaborations in endocrine surgery.

Main Methods:

• Retrospective chart review of 21 adult patients undergoing thyroid surgery during humanitarian trips (2010-2015).
• Postoperative follow-up included medical history, physical examination, laryngoscopy, SF-36 quality-of-life questionnaire, thyroid function tests, and neck ultrasound.
• Mean follow-up duration was 33.6 months.

Main Results:

• No cases of goiter recurrence or malignancy were observed.
• Postoperative hypothyroidism occurred in 37.5% of subtotal thyroidectomy patients and 15.4% of lobectomy patients.
• All patients reported symptomatic improvement, with positive pre- and postoperative SF-36 quality-of-life scores.

Conclusions:

• Long-term surgical and quality-of-life outcomes research is feasible in resource-limited settings.
• Low complication rates suggest safety of thyroid surgery in this context.
• Postoperative hypothyroidism requires individualized, longitudinal, and multidisciplinary care; quality-of-life improvements indicate patient benefit.