Department of Breast & Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi, Zunyi, 563000, China.
BMC Surg. 2021 Jun 3;21(1):277. doi: 10.1186/s12893-021-01267-3.
Compared with conventional open surgery, endoscopic thyroidectomy via the oral vestibular approach (ETVOA) and endoscopic thyroidectomy via the areola approach (ETAA) avoided scarring of the skin, which may help patients achieve a better 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 between ETVOA and ETAA.
131 patients were enrolled in this study. ETAA surgery and ETVOA surgery were performed in 74 patients and 57 patients, respectively. These patients were followed up at 2 weeks, 4 weeks, and 8 weeks, and their QOL was evaluated using a thyroid surgery-specific questionnaire and a short-form health survey (SF-36).
There were no differences in clinical characteristics such as gender, age, body mass index (BMI), and tumor size between the two groups. The volume of intraoperative blood loss, cost of hospitalization, and complications between the two procedures showed no differences. Compared with ETAA, ETVOA has a longer operation time, no drainage, and shorter hospital stay. In the QOL questionnaire, several parameters in ETVOA were better. The satisfaction scores of patients undergoing ETVOA were higher. In addition, the cosmetic satisfaction in patients who received ETOVA was significantly better than that of patients who underwent ETAA. The degree of neck movement disorder in patients with ETVOA was milder. Patients who received ETVOA had higher score on the SF-36.
The trans-oral endoscopic approach can acquire better cosmetic results and achieved high-level QOL.
与传统的开放式手术相比,经口前庭入路内镜甲状腺切除术(ETVOA)和乳晕入路内镜甲状腺切除术(ETAA)避免了皮肤瘢痕,这可能有助于患者获得更好的生活质量(QOL)。然而,该技术的 QOL 获益尚未得到充分研究,因此本研究比较了 ETVOA 和 ETAA 的 QOL 结果。
本研究纳入了 131 例患者。74 例患者接受 ETAA 手术,57 例患者接受 ETVOA 手术。这些患者在 2 周、4 周和 8 周时进行随访,并使用甲状腺手术专用问卷和简明健康调查问卷(SF-36)评估他们的 QOL。
两组患者的性别、年龄、体重指数(BMI)和肿瘤大小等临床特征无差异。两种手术的术中出血量、住院费用和并发症无差异。与 ETAA 相比,ETVOA 的手术时间更长、无需引流、住院时间更短。在 QOL 问卷中,ETVOA 的几个参数更好。接受 ETVOA 的患者的满意度评分更高。此外,接受 ETOVA 的患者的美容满意度明显优于接受 ETAA 的患者。ETVOA 组患者颈部活动障碍程度较轻。接受 ETVOA 的患者的 SF-36 评分更高。
经口内镜入路可获得更好的美容效果和高水平的 QOL。