[Prise en charge chirurgicale des goitres hyperthyroïdiens a Bamako]

To assess the surgical therapy in goiter with hyperthyroidism in a surgical unit of CHU du Point-G.

A retrospective study was conducted, concerning 131 patients having undergone a thyroidectomy for goiter with hyperthyroidism from January 1st 1998 to December 31st 2007.

The files of 131 patients were analysed. The average age of patients was 39.74 years, with 114 women and 17 men. The goiter in Basedow disease was the first indication for surgery in hyperthyroidism (48 cases; 36.6%) followed by toxic adenoma (39; 29.8% of the cases) and toxic multinodular goiter (38; 29% of cases). Ninety patients had a subtotal thyroidectomy (68.7% of cases). One total thyroidectomy (0.8%), 39 isthmolobectomies (29.7%) and one isthmectomy (0.8%) were carried out. Anatomohistology showed 67.1% of colloid benign tumours, and 8 cases of cancers (6.2% of the cases). Early postoperative follow ups were due to hemorrhage (2 cases; 1.5%) and 3 cases of dysphonia (2.5%). One patient died (0.8%). After six months, 3 cases of wound cheloide (2.5%), one case of dysphonia, and one case of hypothyroidism were noted. For 86 patients (71.1%) the postoperative follow up was simple.

Surgery remains a treatment of choice for hyperthyroidism goiter. Other options are too expensive or not available.