How does thyroidectomy for benign thyroid disease impact upon quality of life? A prospective study

Abstract

Background: Choosing which patients to recommend surgery for benign thyroid conditions can be difficult due to the subjective nature of compressive thyroid and hormonal symptoms. The aim of this prospective study was to analyse changes in quality of life (QOL) following thyroid surgery using a validated disease-specific assessment tool, the thyroid-related patient-reported outcome (ThyPRO) questionnaire. Methods: Participants undergoing elective thyroid surgery for benign conditions were recruited. Patient demographics and clinical data were collected. ThyPRO consists of 85 questions grouped into 13 physical, mental and social symptom domains. Patients completed a ThyPRO questionnaire pre-operatively and at 6 weeks and 6 months post-operatively. Thy-PRO items were scored according to protocol to produce 13 subscales. Repeated measures linear models with no random effects were performed using data for each outcome. Results: Results were available for a total of 72 patients. The sample was predominately female (n = 63, 88%) with average age 49.8 years. The majority of patients underwent surgery for multi-nodular goitre. At 6 weeks post-operatively, significant improvement was demonstrated in the goitre, hypothyroid, hyperthyroid and anxiety symptom domains. At 6 months post-operatively, significant improvement was demonstrated in all but four domains. No domains demonstrated significant increase in impairment post-operatively. Conclusion: Patients had significant improvement in nine of 13 symptom domains following surgery. Patients did not experience a negative impact on QOL following surgery. Further studies with larger patient cohorts may be able to identify potential pre-operative predictive factors for a post-operative improvement in QOL for benign thyroid disease.

Quality of Life in Patients with Benign Non‐Toxic Goiter After Surgical Intervention: A Systematic Review and Meta‐Analysis

“…From these, 35 studies did not meet the inclusion criteria. Eleven studies were excluded because of different outcomes [7,15,19,[32][33][34][35][36][37][38][39], nine studies were excluded because of a different population [11,18,20,[40][41][42][43][44][45], three studies evaluated different time points [13,14,46], and one evaluated a different intervention [47]. The remaining eleven studies were either missing the full text, were duplicates, or were written in another language.…”

“…Morbidity after thyroid surgery exists due to complications including recurrent laryngeal nerve (RLN) injury, neck hematoma, symptoms related to hypothyroidism and symptoms related to complications following surgery such as hypoparathyroidism. These outcomes all have a negative impact on HR-QoL [11,12]. Previous studies have utilized diverse survey instruments including non-disease-specific HR-QoL surveys (SF-36) [13][14][15], symptom-specific QoL surveys (SWAL-QOL) [16], and non-validated assessment tools [17].…”

“…The impact of thyroidectomy on QoL specifically in patients with benign goiter has been infrequently studied [11]. A limited number QoL studies in benign goiter used the Thyroid Patient‐Reported Outcome (ThyPRO) questionnaire, the only validated instrument measuring QoL in patients with benign thyroid disease [19, 20].…”

Qualidade de vida em voz e sintomas emocionais pré e pós-tireoidectomia

“…Quanto ao resultado do questionário QVV, não houve diferença estatisticamente significante nos diferentes momentos, porém os menores escores foram autorreferidos no pré-operatório com destaque para o domínio físico em todos os momentos, e melhora progressiva em todos os escores após 3 meses. A presença de sintomatologia vocal antes da tireoidectomia (2,21) pode impactar a qualidade de vida em voz, sobretudo, no domínio físico, e espera-se que com a redução dos sintomas vocais após a cirurgia, ocorra melhora nos domínios relacionados à qualidade de vida (6,22) .…”

Total thyroidectomy for giant nodular goiter guided by pre-operative 3D computed tomography reconstruction and 3D printing: A case report

“…These situations compromise the health-related quality of life. [ 17 ] Sufficient preoperative preparation and standard operation procedure are essential to prevent surgery-related complications. Thyroid imaging comprises ultrasonography, thyroid scintigraphy, CT, and magnetic resonance imaging.…”