TITLE:
Postoperative Outcomes and Pathology-Report Retrievability after Thyroid Surgery at a National Referral Hospital in Burundi: An Ambidirectional Hospital-Based Cohort Study, 2019-2024
AUTHORS:
Lionel Horugavye, Octave Murisho, Gordien Ngendakuriyo, Sixte Nderagakura, Josue Ndayishemeze
KEYWORDS:
Thyroid Surgery, Thyroidectomy, Postoperative Outcomes, Histopathology, Quality Improvement, Burundi
JOURNAL NAME:
Open Access Library Journal,
Vol.13 No.7,
July
27,
2026
ABSTRACT: Background: Thyroidectomy is performed for malignant or suspicious nodules, multinodular goiter, compressive disease, and selected benign thyroid disorders. In referral hospitals with constrained diagnostic and follow-up infrastructure, postoperative morbidity and the availability of final pathology reports are key dimensions of care quality. Methods: We analysed an ambidirectional hospital-based cohort of 265 patients who underwent thyroid surgery at the Centre Hospitalo-Universitaire de Kamenge, Burundi, between 1 September 2019 and 31 August 2024. The primary endpoint was the proportion of cases with a retrievable final histopathology report in the available clinical record. Secondary endpoints were indications, procedure extent, length of stay, chart-documented postoperative outcomes, and availability of recorded TIRADS categories. Wilson 95% confidence intervals (CIs) were calculated for key proportions. Results: Thyroid surgery accounted for 265 of 3431 ENT operations (7.7%; 95% CI, 6.9 - 8.7). Women comprised 239 patients (90.2%), and total thyroidectomy was performed in 173 (65.3%). An uncomplicated immediate postoperative course was documented in 227 patients (85.7%); 38 (14.3%) were classified with at least one recorded complication category. Recorded postoperative hypocalcemia occurred in 29 patients (10.9%; 95% CI, 7.7 - 15.3), including 24 asymptomatic cases, 4 with cramps, and 1 with tetany requiring parenteral calcium gluconate. A final histopathology report was retrievable in 176 cases (66.4%; 95% CI, 60.5 - 71.8); 89 records had no retrievable final report. Six retrievable reports documented malignancy. Paired recorded TIRADS and histopathology data were available in 172 cases; sparse high-risk categories precluded diagnostic-performance analyses. Conclusion: Thyroid surgery at CHUK was associated with measurable chart-documented postoperative morbidity and a substantial gap in final pathology-report retrievability in the available record. Prospective quality-improvement work should prioritize standardized calcium documentation, specimen-to-report tracking, and structured postoperative voice and airway assessment.