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Comparative Study
. 2024 Feb;48(2):379-385.
doi: 10.1002/wjs.12012. Epub 2023 Dec 23.

A comparison of swallowing related quality of life in patients undergoing transoral endoscopic versus open thyroid surgery

Parth Deshmukh  1 , Bharath Shiva  1 , Sanjay Kumar Yadav  1 , Pawan Agarwal  1 , Dhananjaya Sharma  1 , Goonj Johri  2
Affiliations
Comparative Study

A comparison of swallowing related quality of life in patients undergoing transoral endoscopic versus open thyroid surgery

Parth Deshmukh et al. World J Surg. 2024 Feb.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: TOETVA; swallowing disorders; swallowing related quality of life; transoral endoscopic thyroidectomy.

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References

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