Abstract：
It is important for the endoscopic thyroid surgeon to understand the pros and cons of trans-oral endoscopic thyroidectomy-vestibular approach (TOETVA) vis-à-vis, open conventional thyroidectomy (OTx) so he/she can help patients in making informed choices regarding the type of procedure to opt for. Swallowing related quality of life (SWAL-QoL) has not been compared between the two approaches. Using a rigorous qualitative methodology and validated reliable tool, this study set out to compare the swallowing related quality of life in patients undergoing TOETVA versus OTx.
Prospective study at 3 time points in patients planned for hemithyroidectomy (Preoperative, 1 week and 12 weeks). Data were collected on patients at a tertiary teaching institute in India. Participants ranged from age 18-60 years with a diagnosis of benign euthyroid nodule undergoing hemithyroidectomy. Exclusion criteria were-(1) pre-existing vocal cord abnormalities, (2) undergoing surgery for recurrent nodules, and (3) any neuro-muscular disease affecting swallowing ability. Main outcome measure was comparison of swallowing related quality of life domain scores between patients undergoing hemithyroidectomy via either endoscopic trans-oral or open approach.
Of the 82 included patients, 40 underwent TOETVA and 42 OTx. Both the groups were comparable in terms of demographic and clinicopathological profile. The mean preoperative SWAL-QOL scores were comparable in all domains. Mean SWAL-QoL scores for all domains on postoperative day 7 were significantly better in TOETVA group with domains burden, eating desire, mental health and communication having medium effect sizes. Physical symptom domain was better in the OTx group but had a small effect size. The difference in SWAL-QoL domains between the two groups persisted for 3 months also.
Swallowing related quality of life after trans-oral endoscopic thyroidectomy compared to conventional open surgery has not been reported in the literature. Our findings suggest that trans-oral endoscopic thyroidectomy results in significant superior swallowing related quality of life in the majority of domains.
Prospective study at 3 time points in patients planned for hemithyroidectomy (Preoperative, 1 week and 12 weeks). Data were collected on patients at a tertiary teaching institute in India. Participants ranged from age 18-60 years with a diagnosis of benign euthyroid nodule undergoing hemithyroidectomy. Exclusion criteria were-(1) pre-existing vocal cord abnormalities, (2) undergoing surgery for recurrent nodules, and (3) any neuro-muscular disease affecting swallowing ability. Main outcome measure was comparison of swallowing related quality of life domain scores between patients undergoing hemithyroidectomy via either endoscopic trans-oral or open approach.
Of the 82 included patients, 40 underwent TOETVA and 42 OTx. Both the groups were comparable in terms of demographic and clinicopathological profile. The mean preoperative SWAL-QOL scores were comparable in all domains. Mean SWAL-QoL scores for all domains on postoperative day 7 were significantly better in TOETVA group with domains burden, eating desire, mental health and communication having medium effect sizes. Physical symptom domain was better in the OTx group but had a small effect size. The difference in SWAL-QoL domains between the two groups persisted for 3 months also.
Swallowing related quality of life after trans-oral endoscopic thyroidectomy compared to conventional open surgery has not been reported in the literature. Our findings suggest that trans-oral endoscopic thyroidectomy results in significant superior swallowing related quality of life in the majority of domains.
摘要：
背景：对于内镜甲状腺外科医生来说，了解经口内镜甲状腺切除术-前庭入路（TOETVA）的利弊非常重要，开放常规甲状腺切除术（OTx），因此他/她可以帮助患者就选择的手术类型做出明智的选择。两种方法之间尚未比较与吞咽相关的生活质量（SWAL-QoL）。使用严格的定性方法和经过验证的可靠工具，本研究旨在比较接受TOETVA和OTx治疗的患者的吞咽相关生活质量.
方法：计划进行半甲状腺切除术的患者在3个时间点进行的前瞻性研究（术前，1周和12周）。数据是在印度一所高等教育机构收集的。参与者年龄在18-60岁之间，诊断为良性甲状腺正常结节，接受半甲状腺切除术。排除标准是-（1）预先存在的声带异常，（2）复发性结节手术，和(3)任何影响吞咽能力的神经肌肉疾病。主要结局指标是比较通过内镜经口或开放入路进行半甲状腺切除术的患者吞咽相关生活质量领域评分。
结果：在82名患者中，40例接受了TOETVA和42OTx。两组在人口统计学和临床病理特征方面具有可比性。术前平均SWAL-QOL评分在所有领域均具有可比性。术后第7天所有领域的平均SWAL-QoL评分在具有领域负担的TOETVA组显著更好,吃的欲望，心理健康和沟通具有中等效应大小。OTx组的身体症状域更好，但效果较小。两组之间SWAL-QoL域的差异也持续了3个月。
结论：与传统开放手术相比，经口内镜甲状腺切除术后吞咽相关的生活质量尚未见文献报道。我们的发现表明，经口内镜甲状腺切除术在大多数领域都能显著提高吞咽相关的生活质量。
方法：计划进行半甲状腺切除术的患者在3个时间点进行的前瞻性研究（术前，1周和12周）。数据是在印度一所高等教育机构收集的。参与者年龄在18-60岁之间，诊断为良性甲状腺正常结节，接受半甲状腺切除术。排除标准是-（1）预先存在的声带异常，（2）复发性结节手术，和(3)任何影响吞咽能力的神经肌肉疾病。主要结局指标是比较通过内镜经口或开放入路进行半甲状腺切除术的患者吞咽相关生活质量领域评分。
结果：在82名患者中，40例接受了TOETVA和42OTx。两组在人口统计学和临床病理特征方面具有可比性。术前平均SWAL-QOL评分在所有领域均具有可比性。术后第7天所有领域的平均SWAL-QoL评分在具有领域负担的TOETVA组显著更好,吃的欲望，心理健康和沟通具有中等效应大小。OTx组的身体症状域更好，但效果较小。两组之间SWAL-QoL域的差异也持续了3个月。
结论：与传统开放手术相比，经口内镜甲状腺切除术后吞咽相关的生活质量尚未见文献报道。我们的发现表明，经口内镜甲状腺切除术在大多数领域都能显著提高吞咽相关的生活质量。
