OBJECTIVE: To illustrate the clinico-pathological pattern of thyroid disease treated surgically at a tertiary care hospital.
METHODOLOGY:This retrospective and descriptive case study was conducted at Chandka Medical College Hospital, Shaheed Mohtarma Benazir Bhutto Medical University Larkana over a period of Six years from January 2008 to December 2013.
All patients of above 30 years of age admitted to the department of surgery, clinically diagnosed as having goiter, and clinically as well as biochemically euthyroid, were included in the study. Inclusion and exclusion criteria were defined. The data was collected from hospital records on study specific pre-designed forms, which included demographic data, clinical presentation, preoperative and postoperative laboratory investigations, per operative findings, post operative complications, duration of hospital stay, morbidity and mortality if any. Data was recorded and analyzed using SPSS.
RESULTS:A total of 460 patients were included in the study, out of which there were 432 females and 28 males with female to male ratio of 15:1. The mean age was 37.5 years. The definitive diagnosis was made on histopathology, benign lesions were found in 84.34% patients (n=388) cases and malignant in 15.66% (n=72) cases. Papillary carcinoma was found to be the most common malignancy reported in 70% of malignant cases, followed by follicular carcinoma and anaplastic carcinoma accounting for 13% and 7% of malignancies respectively. The most common operative procedure performed was subtotal thyroidectomy, in 322 patients, followed by total thyroidectomies and lobectomies with or without isthmusectomy in 40, and 44 cases respectively. The most common complication was RTI in 9.78% cases, followed by hypoparathyroidism in 3.48% patients. There were only 2(2.83) cases of recurrent laryngeal nerve injury.
CONCLUSION: Multinodular goiter is the most common type of goiter admitted for surgery followed by solitary thyroid nodule hence the most common surgical procedure performed is subtotal thyroidectomy followed by lobectomy with isthmusectomy and total thyroidectomy. Majority of goiters are benign. The most common malignant goiter is of papillary carcinoma, followed by follicular
Key words: Goiter, thyroid, thyroidectomy.
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