Diagnostic and Therapeutic Strategy in the Management of Goiters in a Surgical Setting: Report of 89 Cases

Abstract

Introduction: The goiter is a very common endocrine pathology throughout the world. Objectives: The objectives of our study is to analyse the anatomo-clinical aspects of goiters, its means of investigation, as well as their management in a surgical environment Materials and Methods: Our work is a retrospective study concerning 89 cases operated on for goiter in the general surgery department (wing 3) of the Ibn Rochd University Hospital in Casablanca, over a 2-year period from June 2015 to June 2017. Résultat: The average age of our patients was 49 years old and the sex ratio was 11.71 (82W/7M) The reason for consultation was an asymptomatic mass in 58% of cases. Our patients were euthyroid in 100% of cases. Ultrasound showed a multi-hetero nodular goiter in 89% of cases and 34% of cases were classified as TIRADS 3A. The plunging character was not objectified in any patient. Total thyroidectomy was carried out in 100% of the cases in our series, with a systematic search for recurrent nerves and parathyroid glands. 86% of the cases were benign, while only 14% were malignant, with papillary carcinoma being the most common (9.76% of cases). Conclusion: The diagnostic approach in front of a goiter is based on the search for clinical signs supplemented by multiple paraclinical examinations allowing the orientation of the practitioner and a better definition of the surgical indication.