CHIRURGIE DU GOITRE HYPERTHYROïDIEN AU CHU GABRIEL TOURE (MALI)

The hyperthyroidism is a frequent and serious pathology due to the cardiovascular complications. The objectives were to describe the diagnostic aspects of toxic goiter, to identify the surgical indications and analyse post operative complications. Method: We made a retrospective study at the department of general surgery at the teaching hospital Gabriel Touré Bamako between January 1999 and December 2007. All the patients operated for toxic goiters were retained. Other thyroid pathologies were excluded. The diagnosis of hyperthyroid was made on biology. Results: A total of 295 thyroidectomies has been performed during those 9 years, we retained 102 patients operated for toxic goiter 34.7%. The mean age was 39±12 years (90 females and 12 male). The most frequent signs of hyperthyroidism were: tachycardia (92.15%) palpitation (92.19%) exophthalmia (40.19%). The histological examination found colloids goiters 77% and goiters in activity were of 87%. The multi nodular toxic goiter was the most frequent form 46% follow-up of the Graves disease 32%. The surgical procedure were 80 subtotals thyroidectomies, 14 rigth isthmolobectomies and 8 left isthmolobectomies. We did not carry out total thyroidectomy. The complications were: three cases (2.94%) of haemorrhages after surgery, 4 surgical site infections (3.92%), 2 cases (1.96%) of unilateral transitory injury of recurrent nerve and one case of hypoparathyroidism which did not require a calcic supplementation. The rate of hyperthyroidism recidive in 18 months was 1.96%. Conclusion: The hyperthyroidism is frequent in hospital medium and subtotal thyroidectomy remains a good surgical technique in our sub-Saharan countries of Africa. Keys words: goiter, hyperthyroidism, surgery, complications.