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    Experience with managing retrosternal goitres in ibadan, Nigeria
    (Wolters Kluwer - Medknow, 2016) Ayandipo, O. O.; Afolabi, A. O.; Afuwape, O. O.; Bolaji, B. E.; Salami, M. A.
    Background: There is no general consensus on the definition of retrosternal goitre however thyroidectomy remains the gold standard of treatment with or without a sternotomy Aim: To review the outcome of surgical management of retrosternal goitres. Methodology: Retrospective review of records of patients who had thyroidectomy for retrosternal goitre over a 15-year period. Results: Out of a total of 45 patients, 34(76%) were females and 11(24%) were males with a male/female ratio of 3:1; while their age ranged between 28 and 72years with a mean of 57+15SD. All the patients were euthyroid and a quarter did not have symptoms apart from a neck mass. In all, 15% of the patients had recurrent goitre. CT scan of neck and chest was done in 31 (72%) patients; while 44 (98%) patients had cervical retrosternal goitres, 1(2%) patient had ectopic retrosternal goitre. A cervical incision was sufficient in 28 (62%) patients while 17 (38%) patients required additional sternotomy. Total thyroidectomy was done in all the patients. There were post-operative complications in 19 (42%) patients. Histopathology showed that 3(6.6%) patients had papillary thyroid carcinoma while 42(93.4%) had benign pathology findings. Conclusion: Surgical removal is the treatment of choice. Most retrosternal goitres can be resected through a collar stud incision; however the possibility of a need for a sternotomy should always be planned. The simultaneous occurrence of cervical and ectopic retrosternal goitre should always be ruled out with a CT scan.
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    A fifteen year experience of total thyroidectomy for the management of simple multinodular goitres in a low medium income country
    (Association of Surgeons of South Africa, 2016) Afolabi, A. O.; Ayandipo, O. O.; Afuwape, O. O.; Ogundoyin, O. A.
    Introduction: Total thyroidectomy as a treatment for simple multinodular goitre is not well recognised in most centres in low middle income countries. Methods: This paper is a retrospective review of outcomes of total thyroidectomy for simple multinodular goitres in the last fifteen years in a tertiary hospital in Nigeria. Results: A total of 652 thyroidectomies were done from January 2001 to December 2015. Simple multinodular goitres were indication for a total thyroidectomy in 447 patients (68.6%) with a male to female ratio of 1:6. Postoperative complications were hypocalcaemia in 22 (4.9%), unilateral recurrent laryngeal nerve palsy in 13 (2.8%) and haemorrhage in 2 patients. Others were seroma and cellulitis. Tracheostomy was required in 35 (5.8%) patients but none was permanent. Conclusion: Total thyroidectomy is a relatively safe treatment option for patients who have simple multinodular goitre. It provides a permanent cure with a low postoperative morbidity risk. The burden of replacement l-thyroxine needs to be discussed with the patients.