Journal List > Korean J Endocr Surg > v.10(3) > 1060004

M.D., M.D., M.D., and M.D.: Comparison of Endoscopic Thyroidectomy versus Conventional Thyroidectomy in Patient Satisfaction with Cosmetic Result

Abstract

Purpose:

Endoscopic thyroidectomy has brought lots of advantages to the patients since its first introduction. The aim of this study is to evaluate the functional and cosmetic satisfaction of patients receiving endoscopic thyroidectomy with patients receiving conventional thyroidectomy.

Methods:

From October 2009 to January 2010, 98 patients underwent with conventional (n=69) or endoscopic (n=22) thyroidectomy. Of these patients 91 who had responded to a questionnaire distributed during the visit outpatient clinic visit. The questionnaire responses were analyzed to compare the satisfaction and postoperative results of these patients.

Results:

The patient mean age was 45.5±10.1 years and the male to female ratio was 1:8.1. Perceived cosmetic satisfaction was significantly greater in patients who received conventional thyroidectomy than in those who received endoscopic thyroidectomy (P=0.03). Otherwise, there were no significant differences concerning functional problems. The conventional surgery was significantly longer than the endoscopic surgery (P=0.001). However, there were no significant differences in estimated blood loss, postoperative hospital stayand complication rates (P>0.05).

Conclusion:

Endoscopic thyroidectomy might bring satisfactory cosmetic result compared to conventional thyroidectomy. However, further studies are necessary. (Korean J Endocrine Surg 2010;10:170-175)

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Fig. 1
Conventional thyroidectomy.
kjes-10-170f1.tif
Fig. 2
Endoscopic thyroidectomy.
kjes-10-170f2.tif
Table 1.
Characteristics of the patients
  Conventional (n=69) Endoscopic (n=22) P value
Age (mean) 46.5±10.7 42.0±7.3 0.063
Male:Female 1:6.7 1:21 0.441
Benign:Malignancy 1:6.7 1:10 1.000
Operation method     <0.001
Total thyroidectomy 58 0  
Near total thyroidectomy 2 0  
Lobectomy 9 22  
Table 2.
Surgical outcomes
  Conventional (n=69) Endoscopic (n=22) P value
Operation time (mean) 137.4±47.1 min. 173.6±50.4 min. 0.001
Lobectomy 96.7±27.0 min. 173.6±50.4 min. <0.001
Near total thoidectomy 165±84.9 min.    
Total thyroidectomy 142.9±45.7 min.    
EBL (mean) 57.5±95.3 ml 43.6±52.8 ml 0.104
Lobectomy 36.7±26.0 ml 43.6±52.8 ml 0.534
Near total thoidectomy 405±558.6 ml    
Total thyroidectomy 48.6±27.2 ml    
Postoperative hospital stay 3.8±1.3 days 3.2±0.4 days 0.054
Lobectomy 3.2±1.2 days 3.2±0.4 days 0.140
Near total thoidectomy 5.0±0 days    
Total thyroidectomy 3.8±1.2 days    
Number of harvest lymph nodes 10.1±7.9 3.8±4.0 <0.001
Lobectomy 7.1±6.4 3.8±4.0 P=0.188
Near total thoidectomy 3.0±4.2    
Total thyroidectomy 10.8±8.1    
Postoperative hypocalcemia 18 2 0.139
Lobectomy 0 2 0.358
Near total thoidectomy 0    
Total thyroidectomy 18    
Postoperative voice change 6 3 0.682
Lobectomy 2 3 0.562
Near total thoidectomy 1    
Total thyroidectomy 3    
Table 3.
The results of questionnaire
  Conventional (n=69) (Mean score) Endoscopic (n=22) (Mean score) P value
For patients      
Pain 2.2 2.4 0.183
Cosmetic satisfaction 2.4 1.6 0.003
Neck discomfort 2.4 2.4 0.743
Voice change 2 1.8 0.520
Difficulty in higher voice tone 2.3 1.9 0.136
Numbness 1.8 1.5 0.196
Overall satisfaction 1.8 1.5 0.053
Desiability of operation method 2.2 1.9 0.152
For doctors      
Vascularity 1.7 1.5 0.387
Pigmentation 2.0 1.8 0.195
Piability 2.1 2.1 0.932
Height 1.8 1.6 0.094
Table 4.
The results of questionnaire for patients who underwent lobectomy
  Conventional (n=9) (Mean score) Endoscopic (n=22) (Mean score) P Value
For patients      
Pain 2.1 2.4 0.265
Cosmetic satisfaction 1.8 1.6 0.555
Neck discomfort 1.9 2.4 0.115
Voice change 1.6 1.8 0.752
Difficulty in higher voice tone 2.2 1.9 0.336
Numbess 1.1 1.5 0.198
Overall satisfaction 1.3 1.5 0.874
Desiability of operation method 2.0 1.9 0.816
For doctors      
Vascularity 1.6 1.5 0.569
Pigmentation 2.0 1.8 0.338
Piability 2.0 2.0 0.799
Height 1.8 1.6 0.625
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