Current Place of Surgery in the Management of Thyroid Disease: A Series of 100 Cases

Abstract: Background: Thyroid disorders are among the most common endocrine diseases and predominantly affect women. Surgery plays a central role, particularly for large or compressive goitres, dysthyroidism refractory to medical treatment, and suspected malignancy. The aim of this study was to define the indications for thyroidectomy and to assess its outcomes in a Moroccan hospital series. Methods: Single-centre retrospective study of 100 patients operated on for thyroid disease in the Department of Surgery B, Ibn Sina University Hospital, Rabat, over a 15-month period (September 2021 – December 2022). Epidemiological, clinical, paraclinical, therapeutic, pathological and follow-up data were collected using a standardised data sheet and analysed in Microsoft Excel. Results: The median age was 47.5 years (range 20–77) with marked female predominance (91%, female-to-male ratio ≈ 10). Anterior cervical swelling was the leading complaint (90%); compressive signs were present in 27% of cases. Cervical ultrasound, performed in 98% of patients, showed a multinodular goitre in 71% and classified most nodules as EU-TIRADS 3 (58%). The main surgical indications were multinodular goitre (36%) and suspected malignancy (21%). Total thyroidectomy was the reference procedure (84%), with lobo-isthmectomy reserved for solitary nodules (12%). No recurrent laryngeal nerve injury and no death occurred. Postoperative hypocalcaemia, mostly biochemical and transient, occurred in 19% of cases. Histopathology revealed benign nodular hyperplasia in 55% and a malignant or borderline lesion in about 20%, papillary carcinoma being the commonest. Conclusion: Thyroidectomy, whether total or partial, remains the gold standard for surgical thyroid disease. A standardised technique with systematic identification of the recurrent laryngeal nerves and parathyroid glands achieved low morbidity and nil mortality. Postoperative follow-up, undermined by a high loss-to-follow-up rate, remains the key area to strengthen.