经口内镜甲状腺手术与传统开放手术患者生活质量的比较。
Comparison of quality of life between patients undergoing trans-oral endoscopic thyroid surgery and conventional open surgery.
作者信息
Kasemsiri Pornthep, Trakulkajornsak Srongpaun, Bamroong Piyapong, Mahawerawat Kanokkarn, Piromchai Patorn, Ratanaanekchai Teeraporn
机构信息
Skull Base Surgery Unit, Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine at the Khon Kaen University, Khon Kaen, 40002, Thailand.
Khon Kaen Head and Neck Oncology Research, Khon Kaen, Thailand.
出版信息
BMC Surg. 2020 Jan 29;20(1):18. doi: 10.1186/s12893-020-0685-3.
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.
背景
经口内镜甲状腺切除术可避免颈部瘢痕，有望提高生活质量（QOL）。然而，该技术对生活质量的益处尚未得到充分研究，因此，本研究比较了经口内镜甲状腺切除术与传统开放手术在生活质量结果（包括美容效果）方面的差异。
方法
本研究于2017年1月30日至2018年11月10日进行。分别有32例和38例患者接受了经口内镜甲状腺手术和传统开放手术。术后2周、6周和12周使用甲状腺手术专用问卷和36项简短问卷对他们的生活质量进行评估。
结果
经口内镜组患者更年轻，甲状腺结节更小（p<0.05）。关于手术结果，两组之间无统计学显著差异。经口内镜组的平均手术时间明显更长（p<0.05）。经口内镜组的生活质量参数明显优于传统手术组（p<0.05）。这些参数包括术后2周时身体活动减少、心理社会损害、身体功能和情绪方面；术后6周时吞咽障碍、心理社会损害、身体功能、社会功能和心理健康方面；术后12周时刺痛和活力感方面。在我们所有的随访时间点，经口内镜组的美容效果和总体满意度均明显优于传统手术组（p<0.05）。
结论
经口内镜手术方法可实现皮肤真正无瘢痕，具有更好的美容效果和生活质量结果。
试验注册
本试验于2017年3月4日在ClinicalTrial.gov（NCT03048539）进行回顾性注册。
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