Comparison of quality of life between patients undergoing trans-oral endoscopic thyroid surgery and conventional open surgery

Pornthep Kasemsiri, Srongpaun Trakulkajornsak, Piyapong Bamroong, Kanokkarn Mahawerawat, Patorn Piromchai, Teeraporn Ratanaanekchai, Pornthep Kasemsiri, Srongpaun Trakulkajornsak, Piyapong Bamroong, Kanokkarn Mahawerawat, Patorn Piromchai, Teeraporn Ratanaanekchai

Abstract

Background: Trans-oral endoscopic thyroidectomy allows obviating scar of the neck that expects to gain quality of life (QOL). However, the benefit of the QOL from this technique has not been adequately investigated, therefore, this study compared the QOL outcomes, including cosmetic outcomes, between thyroidectomy by trans-oral endoscopy and conventional open surgery.

Methods: A study was conducted from January 30, 2017 to November 10, 2018. Thirty-two and 38 patients underwent trans-oral endoscopic thyroid surgery and conventional open surgery, respectively. Their quality of life was evaluated at 2, 6, and 12 weeks postoperatively using a thyroid surgery-specific questionnaire and a 36-item short-form questionnaire.

Results: Trans-oral endoscopic group, patients were younger and presented with smaller thyroid nodules (p < 0.05). Regarding surgical outcomes, there were no statistically significant differences between the two groups. Mean operative time was significantly longer in the trans-oral endoscopic group (p < 0.05). The quality of life parameters in the trans-oral endoscopic group was significantly better than in the conventional surgery group (p < 0.05). These parameters included reduction of physical activity, psychosocial impairment, the role of physic, and emotion at 2 weeks after surgery; swallowing impairment, psychosocial impairment, the role of physic, social function and mental health 6 weeks after surgery; tingling and feeling of vitality at 12 weeks after surgery. Cosmetic outcomes and overall satisfaction were significantly better in the trans-oral endoscopic group than in the conventional surgery group at all of our follow up times (p < 0.05).

Conclusions: The trans-oral endoscopic approach allows real scarless on the skin with better cosmetic and QOL outcomes.

Trial registration: This trial was retrospectively registered at the ClinicalTrial.gov (NCT03048539), registered on 4 March 2017.

Keywords: Endoscopy; Quality of life; Scarring; Thyroidectomy.

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Choi Y, Lee JH, Kim YH, Lee YS, Chang H-S, Park CS, Roh MR. Impact of postthyroidectomy scar on the quality of life of thyroid cancer patients. Ann Dermatol. 2014;26(6):693–699. doi: 10.5021/ad.2014.26.6.693.
    1. Duncan TD, Rashid Q, Speights F, Ejeh I. Transaxillary endoscopic thyroidectomy: an alternative to traditional open thyroidectomy. J Natl Med Assoc. 2009;101(8):783–787. doi: 10.1016/S0027-9684(15)31006-3.
    1. Huscher CS, Chiodini S, Napolitano C, Recher A. Endoscopic right thyroid lobectomy. Surg Endosc. 1997;11(8):877. doi: 10.1007/s004649900476.
    1. Huang JK, Ma L, Song WH, Lu BY, Huang YB, Dong HM. Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma. OncoTargets Ther. 2016;9:4053–4059. doi: 10.2147/OTT.S99980.
    1. Prete FP, Marzaioli R, Lattarulo S, Paradies D, Barile G, d’Addetta MV, Tomasicchio G, Gurrado A, Pezzolla A. Transaxillary robotic-assisted thyroid surgery: technique and results of a preliminary experience on the Da Vinci xi platform. BMC Surg. 2019;18(Suppl 1):19. doi: 10.1186/s12893-019-0473-0.
    1. Cho YU, Park IJ, Choi KH, Kim SJ, Choi SK, Hur YS, Ahn SI, Hong KC, Shin SH, Kim KR, Woo ZH. Gasless endoscopic thyroidectomy via an anterior chest wall approach using a flap-lifting system. Yonsei Med J. 2007;48(3):480–487. doi: 10.3349/ymj.2007.48.3.480.
    1. Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, Kitajima M. Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech. 2000;10(1):1–4. doi: 10.1097/00019509-200002000-00001.
    1. Park YL, Han WK, Bae WG. 100 cases of endoscopic thyroidectomy: breast approach. Surg Laparosc Endosc Percutan Tech. 2003;13(1):20–25. doi: 10.1097/00129689-200302000-00005.
    1. Kim YS, Joo KH, Park SC, Kim KH, Ahn CH, Kim JS. Endoscopic thyroid surgery via a breast approach:a single institution’ s experiences. BMC Surg. 2014;14:49. doi: 10.1186/1471-2482-14-49.
    1. Lee DY, Baek SK, Jung KY. Endoscopic thyroidectomy: retroauricular approach. Gland Surg. 2016;5(3):327–335. doi: 10.21037/gs.2015.10.01.
    1. Twisk J. Applied longitudinal data analysis for Epidemiology: A practical guide. 2nd ed. New York: Cambridge university press; 2013.
    1. Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg. 2016;40(3):491–497. doi: 10.1007/s00268-015-3320-1.
    1. Wang Y, Yu X, Wang P, Miao C, Xie Q, Yan H, Zhao Q, Zhang M, Xiang C. Implementation of intraoperative Neuromonitoring for Transoral endoscopic thyroid surgery: a preliminary report. J Laparoendosc Adv Surg Tech A. 2016;26(12):965–971. doi: 10.1089/lap.2016.0291.
    1. Pisanu A, Porceddu G, Podda M, Cois A, Uccheddu A. Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy. J Surg Res. 2014;188(1):152–161. doi: 10.1016/j.jss.2013.12.022.
    1. Gambardella C, Polistena A, Sanguinetti A, Patrone R, Napolitano S, Esposito D, Testa D, Marotta V, Faggiano A, Calo PG, Avenia N, Conzo G. Unintentional recurrent laryngeal nerve injuries following thyroidectomy: is it the surgeon who pays the bill? Int J Surg. 2017;41(Suppl 1):S55–S59. doi: 10.1016/j.ijsu.2017.01.112.
    1. Deniwar A, Bhatia P, Kandil E. Electrophysiological neuromonitoring of the laryngeal nerves in thyroid and parathyroid surgery: a review. World J Exp Med. 2015;5:120–123. doi: 10.5493/wjem.v5.i2.120.
    1. Fontenot TE, Randolph GW, Setton TE, Alsaleh N, Kandil E. Does intraoperative nerve monitoring reliably aid in staging of total thyroidectomies? Laryngoscope. 2015;125:2232–2235. doi: 10.1002/lary.25133.
    1. Kim WW, Jung JH, Lee J, Kang JG, Baek J, Lee WK, Park HY. Comparison of the quality of life for thyroid Cancer survivors who had open versus robotic thyroidectomy. J Laparoendosc Adv Surg Tech A. 2016;26(8):618–624. doi: 10.1089/lap.2015.0546.
    1. Lee J, Yun JH, Nam KH, Soh EY, Chung WY. The learning curve for robotic thyroidectomy: a multicenter study. Ann Surg Oncol. 2011;18(1):226–232. doi: 10.1245/s10434-010-1220-z.
    1. Park JH, Lee J, Hakim NA, et al. Robotic thyroidectomy learning curve for beginning surgeons with little or no experience of endoscopic surgery. Head Neck. 2015;37(12):1705–1711. doi: 10.1002/hed.23824.
    1. Bakkar S, Al Hyari M, Naghawi M, Corsini C, Miccoli P. Transoral thyroidectomy: a viable surgical option with unprecedented complications-a case series. J Endocrinol Investig. 2018;41(7):809–813. doi: 10.1007/s40618-017-0808-6.
    1. Takamura Y, Miyauchi A, Tomoda C, Uruno T, Ito Y, Miya A, Kobayashi K, Matsuzuka F, Amino N, Kuma K. Stretching exercises to reduce symptoms of postoperative neck discomfort after thyroid surgery: prospective randomized study. World J Surg. 2005;29(6):775–779. doi: 10.1007/s00268-005-7722-3.
    1. Gambardella C, Patrone R, Di Capua F, Offi C, Mauriello C, Clarizia G, Andretta C, Polistena A, Sanguinetti A, Calo P, Docimo G, Avenia N, Conzo G. The role of prophylactic central compartment lymph node dissection in elderly patients with differentiated thyroid cancer: a multicentric study. BMC Surg. 2019;18(Suppl 1):110. doi: 10.1186/s12893-018-0433-0.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren