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Endoscopic versus Conventional Thyroid Surgery: A Comparison of Quality of Life, Cosmetic Outcomes and Overall Patient Satisfaction with Treatment

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Abstract

Background

Our aim was to investigate whether the surgical approach, i.e. endoscopic (ET) versus conventional/open thyroidectomy (ConT), contributes towards the improvement in quality of life (QoL), cosmetic outcomes and overall patient satisfaction with treatment.

Methods

We conducted a prospective study (October 2016–August 2018) consisting of patients undergoing hemithyroidectomy for euthyroid, non-malignant solitary thyroid nodules (STNs). Patients were divided into two groups: Group I (ET)—41 patients and Group II (ConT)—52 patients. ET was performed via bilateral-axillo breast approach (BABA). A thyroid disease-specific questionnaire “ThyPRO-39hin” was used to evaluate pre- and post-operative QoL. Visual analogue scale (VAS) was used for post-operative pain. Cosmetic satisfaction, paraesthesia and overall satisfaction with treatment were evaluated using Likert-type verbal response scales. Pre- and post-operative scores (>6 months) were compared, and p value < 0.05 was considered significant.

Results

Mean age (p = 0.26), gender distribution (p = 0.07), mean tumour size (p = 0.74) and preoperative scores of QoL were comparable between the two groups. Post-operatively scores of symptom domain (p = 0.03), tiredness (p = 0.03), impaired social life (p = 0.03), cosmetic complaints (p =  < 0.001) and overall QoL (p =  < 0.001) were significantly better in Group I. Also, post-operative pain perception at first follow-up visit (p = 0.001) was lower in patients undergoing ET/Group I, with higher scar satisfaction scores (p =  < 0.001) and overall satisfaction with treatment (p =  < 0.001). Post-operative paraesthesia perception was comparable (p = 0.06) amongst the two groups.

Conclusion

In this cohort study, patients undergoing endoscopic thyroid surgery reported superior post-operative QoL, cosmetic and overall satisfaction with treatment as compared to conventional/open thyroidectomy.

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Acknowledgement

We are deeply indebted to Dr. Torquil Watt (Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark) for providing “ThyPRO-39hin” questionnaire. We are extremely grateful to Dr. Prabhaker Mishra, PhD, Associate Professor, Department of Biostatistics and Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli road, Lucknow-226014, for his constant help and guidance with the statistical analysis.

Funding

No funding/grants were received for this study.

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Authors and Affiliations

  1. Department of Breast and Endocrine Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar, 751024, India

    Goonj Johri MS,MCh

  2. Department of Endocrine Surgery, SGPGIMS, Lucknow, India

    Gyan Chand, Anjali Mishra, Sabaretnam Mayilvaganan, Gaurav Agarwal, Amit Agarwal & Saroj Kanta Mishra

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  1. Goonj Johri MS,MCh
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  2. Gyan Chand
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Correspondence to Goonj Johri MS,MCh.

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Informed consent was obtained from all individual participants included in the study.

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Disclosure Part of these data were presented at the Society of Endoscopic and Laparoscopic Surgeons of India (SELSICON) held at BHU, Varanasi, 28-30 September, 2018, in the Best Oral Paper Session.

This work was conducted as a part of MCh trainee research project, at the Department of Endocrine surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India.

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Johri, G., Chand, G., Mishra, A. et al. Endoscopic versus Conventional Thyroid Surgery: A Comparison of Quality of Life, Cosmetic Outcomes and Overall Patient Satisfaction with Treatment. World J Surg 44, 4118–4126 (2020). https://doi.org/10.1007/s00268-020-05732-7

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