Ishtiaq Ahmed, Zaheer Iqbal Awan, Saleem Ahmed Khan, Shahid Rasul, Sundas Ishtiaq.
Giant goiter: not common in endemic areas of Pakistan. a 10 years experience.
Isra Med J Jan ;5(2):121-6.

OBJECTIVES: To determine the prevalence of giant goiter and morbidity after surgery and to compare the data with the national and international literature. STUDY DESIGN: A prospective, observational study. PLACE AND DURATION: Department of Surgery, Fauji Foundation Hospital, Rawalpindi from May 1999 to April 2008. METHODOLOGY: All patients with giant multinodular goiter (Grade IV) were operated and prevalence of compilations was recorded meticulously, and data compared with national and international literature. RESULTS: A total of 744 patients operated and majority were female 94.89% (n=706) from 5 decade of life i.e. 35.75% (n=266). Giant multinodular goiter (Grade IV) found in 26.08% (n=194). Among them, 96.90% (n=188) were euthyroid. Near total thyroidectomy was done in 59.79% (n=116) patients, total thyroidectomy in 28.86% (n=56) and subtotal thyroidectomy in 11.35% (n=22) patients. Transient hypocalcaemia was the commonest complication observed, in 8.24% (n=16) patients followed by seroma formation- 7.21%, (n=14). Permanent hopoparathyroidism 2.66%, (n=4), Permanent recurrent laryngeal nerve injury- 1.03%, (n=2), transient recurrent laryngeal nerve palsy 4.63%, (n=9), postoperative bleeding- 1.03%, (n=2) and wound infection noticed in 2.57% (n=5) patients. CONCLUSION: Giant goiter is not uncommon in our setup, with expected high postoperative complications so surgery should be done by experienced hands in the centers where all facilities are available. Public awareness should be created by health authorities and organizations regarding prevention and early treatment.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com