Surgical management of toxic goitre in Khartoum

Seventy patients with toxic goitre treated surgically in two surgical firms in Khartoum during a 10-years period were studied. Of these patients 62.9% had diffuse goitres, 34.3% nodular and 2.8% hot clinically solitary nodules. The age ranged between 15 and 54 years and the M:F ratio was 1.0:6.7. Ninety per cent of the patients had large size goitres (grade III). Preoperative carbimazole and inderal were found to be superior to other drug combinations. Subtotal thyroidectomy was the standard procedure and no serious postoperative complications were noted. Fifteen patients had postoperative hectic period i.e. fever, headache and tachycardia that responded to temporary inderal and steroids. Surgical treatment of toxic goitre in developing countries could be extended to include more patients since drug availability and patient compliance are minimal.