title: Thyroid surgery at a volunteer program in Sub-Saharan Africa.
abstract: BACKGROUND
  The aim of this study is to demonstrate our experience at a volunteer surgical program in Cameroon, which is of special interest given to the inability to adopt international treatment guidelines for thyroid surgery in areas of limited resources due to the lack of preoperative testing and to the difficulty to obtain sustitutive hormonal treatment.
  
  
  METHODS
  This is a prospective observational study that includes 16 cases of thyroid surgery in Dschang (Cameroon) during June 2015. The patients were previously selected by a local medical team. All patients were black, 15 women and one man, with a mean age of 41 years. The surgical technique used for the removal of unilateral disease was hemithyroidectomy with isthmectomy and bilateral subtotal thyroidectomy for bilateral disease.
  
  
  RESULTS
  Five subtotal thyroidectomies, 9hemithyroidectomies and 2isthmectomies were performed. Prethyroid muscles were divided only in one case. We visualized 86% of the parathyroid glands and 84% of the recurrent laryngeal nerves. The main complications observed were one symptomatic cervical haematoma that required reoperation and 2surgical wound infections. There were no clinical episodes of hypocalemia or recurrent nerve lesion. The mean length of stay was 2.3 days. At follow-up, all bilateral thyroidectomies developed high TSH levels.
  
  
  CONCLUSIONS
  Thyroid surgery is safe in developing countries adopting protocols and techniques we use in our environment (avoiding total thyroidectomy). Bilateral thyroidectomies should not be performed unless functional studies are available in the follow-up and a thyroid hormone supplement stock guaranteed whenever necessary.
authors.affiliation: Servicio de CGD, Hospital Universitario Fuenlabrada, Madrid, España. Electronic address: fernando.pereira@salud.madrid.org.
authors.forename: Fernando
authors.initials: F
authors.lastname: Pereira Pérez
authors.affiliation: Servicio de CGD, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: Pablo
authors.initials: P
authors.lastname: Calvo Espino
authors.affiliation: Servicio de CGD, Hospital Universitario Gregorio Marañón, Madrid, España.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Sánchez Arteaga
authors.affiliation: Servicio de CGD, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: Joaquín Manuel
authors.initials: JM
authors.lastname: Muñoz Rodriguez
authors.affiliation: Hospital de Notre Dame de Sante - Batseng'la, Dschang, Camerún.
authors.forename: Lionel W
authors.initials: LW
authors.lastname: Nges
authors.affiliation: Hospital de Notre Dame de Sante - Batseng'la, Dschang, Camerún.
authors.forename: Mireille
authors.initials: M
authors.lastname: Kemmoe
authors.affiliation: Servicio de Anestesia, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Vidal Fernández
authors.affiliation: Servicio de Anestesia, Hospital Quirón Pozuelo, Madrid, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Blázquez
authors.affiliation: Estudiante de Medicina, Universidad Autónoma, Madrid, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Vives Espejo-Saavedra
authors.affiliation: Estudiante de Medicina, Universidad Autónoma, Madrid, España.
authors.forename: Marina
authors.initials: M
authors.lastname: Picón Maroñas
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: Andrés
authors.initials: A
authors.lastname: Varela de Ugarte
mesh_terms: D000328:Adult; D002163:Cameroon; D005260:Female; D006042:Goiter / Q000601:surgery*; D006801:Humans; D007391:International Cooperation; D008297:Male; D011446:Prospective Studies; D013965:Thyroidectomy; D017664:Uncompensated Care
keywords: Bocio endémico; Cirugía general; Cooperación sanitaria; Endemic goiter; Equipamiento quirúrgico; General surgery; Nódulo tiroideo; Surgical aid program; Surgical equipment; Thyroid gland; Thyroid nodule; Thyroidectomy; Tiroidectomía; Tiroides