Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Otolaryngol Head Neck Surg. 2024 Jul;171(1):45-53. doi: 10.1002/ohn.712. Epub 2024 Mar 15.
To compare long-term health-related quality of life (HRQOL) after Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) and transcervical approach (TCA) thyroidectomy.
Prospective cohort study.
Tertiary referral center.
A web-based survey was distributed to patients at our institution who met the criteria for TOETVA and underwent thyroidectomy by TOETVA or TCA between August 2017 and October 2021. All survey participants were at least 6 months postsurgery. Minors, non-English speakers, and patients who received concomitant neck dissection or reoperative thyroidectomy were excluded from the study. The survey assessed quality of life through 4 standardized instruments: the Dermatology Life Quality Index (DLQI), the Eating Assessment Tool (EAT-10), the Voice Handicap Index (VHI-10), and the Short Form Health Survey (SF-36).
A total of 108 TOETVA and 129 TCA patients were included in the study. The median age of respondents was 44 (36, 54; 25th, 75th percentile) years and median time from surgery to survey was 35 (22, 45; 25th, 75th percentile) months. TOETVA group DLQI (0.63 vs 0.99; P = .17), VHI-10 (1.94 vs 1.67; P = .35), EAT-10 (2.14 vs 2.32; P = .29), SF-36 physical component (52.25 vs 51.00; P = .25), and SF-36 mental component (47.74 vs 47.29; P = .87) scores were all similar to those of the TCA group. Scrutinizing specific DLQI questions, individuals in the TOETVA group were less self-conscious of their skin as compared to the TCA group (Q2; 0.08 vs 0.26, P = .03).
Long-term HRQOL after TOETVA is similar to TCA, with significantly lower skin-related self-consciousness.
比较经口内镜甲状腺手术喉罩入路（TOETVA）与经颈入路（TCA）甲状腺切除术的长期健康相关生活质量（HRQOL）。
前瞻性队列研究。
三级转诊中心。
我们向我院符合 TOETVA 标准并于 2017 年 8 月至 2021 年 10 月期间接受 TOETVA 或 TCA 甲状腺切除术的患者发放了在线调查。所有调查参与者均在术后至少 6 个月。未成年人、非英语使用者以及接受同期颈部清扫术或再次甲状腺切除术的患者被排除在研究之外。该调查通过 4 种标准化工具评估生活质量：皮肤病生活质量指数（DLQI）、饮食评估工具（EAT-10）、嗓音障碍指数（VHI-10）和简明健康调查量表（SF-36）。
共有 108 名 TOETVA 和 129 名 TCA 患者纳入研究。受访者的中位年龄为 44（36，54；25 百分位数，75 百分位数）岁，自手术至调查的中位时间为 35（22，45；25 百分位数，75 百分位数）个月。TOETVA 组的 DLQI（0.63 比 0.99；P =.17）、VHI-10（1.94 比 1.67；P =.35）、EAT-10（2.14 比 2.32；P =.29）、SF-36 生理成分（52.25 比 51.00；P =.25）和 SF-36 心理成分（47.74 比 47.29；P =.87）评分均与 TCA 组相似。仔细观察特定的 DLQI 问题，TOETVA 组的个体在皮肤方面的自我意识明显低于 TCA 组（Q2；0.08 比 0.26，P =.03）。
TOETVA 后的长期 HRQOL 与 TCA 相似，皮肤相关的自我意识明显较低。
