Felix Cherian, Russell Jonathon O, Juman Solaiman, Medford Steve
The University of the West Indies, Department of Otolaryngology, Head and Neck Surgery, St. Augustine, Trinidad.
Johns Hopkins Medicine, Division of Head and Neck and Endocrine Surgery, Department of Otolaryngology, Head and Neck Surgery, Baltimore, MD, USA.
Gland Surg. 2019 Dec;8(6):723-728. doi: 10.21037/gs.2019.11.17.
Thyroidectomy is a commonly performed procedure with large centres performing thousands of thyroid surgeries per year. The traditional Kocher mid-cervical incision has been the standard approach to thyroidectomy since the late 1870s with predictable results. The introduction of minimally invasive and remote access techniques seeks to reduce the morbidity of a mid-cervical scar incision.
Ninety-five [95] patients who underwent this approach over the thirty [30] months period from January 2015 to July 2017 were administered the validated Patient Scar Assessment Questionnaire and the collected data analysed.
Forty-eight [48] patients, (50.5%) met inclusion criteria and provided responses with a mean time since surgery of 18.9 months. There is a high level of satisfaction with 91.7% of patients in the study having scores consistent with scar satisfaction after conventional thyroidectomy. While patients were satisfied with the appearance of their scars, a majority of patients (n=28, 58.3%) were at least slightly conscious of their incisions, with more than 10% of patients (n=5) reporting significant levels of self-consciousness. Patients of Mixed race were found to have slightly elevated scores on PSAQ compared with IndoTrinidadian and AfroTrinidadian races (P=0.002 and P=0.006).
Most patients were satisfied with their scar results in the years after thyroidectomy. Despite the high level of satisfaction, a majority of patients are self-conscious about the presence of a mid-cervical incision. Further research is needed to elucidate causes and the effects of this finding.
甲状腺切除术是一种常见的手术,大型中心每年会进行数千例甲状腺手术。自19世纪70年代末以来,传统的科赫尔颈部正中切口一直是甲状腺切除术的标准方法,效果可预测。微创和远程接入技术的引入旨在降低颈部正中瘢痕切口的发病率。
对2015年1月至2017年7月这30个月期间接受该手术方法的95例患者进行了经过验证的患者瘢痕评估问卷调查,并对收集的数据进行了分析。
48例(50.5%)患者符合纳入标准并提供了回复,术后平均时间为18.9个月。满意度较高,研究中91.7%的患者得分与传统甲状腺切除术后的瘢痕满意度一致。虽然患者对瘢痕外观满意,但大多数患者(n = 28,58.3%)至少对自己的切口略有在意,超过10%的患者(n = 5)报告有明显的自我意识。发现混血患者在PSAQ上的得分比印度裔特立尼达人和非裔特立尼达人略高(P = 0.002和P = 0.006)。
大多数患者在甲状腺切除术后数年对其瘢痕结果感到满意。尽管满意度较高,但大多数患者对颈部正中切口的存在仍有自我意识。需要进一步研究以阐明这一发现的原因和影响。