Endoscopic versus Conventional Thyroid Surgery: A Comparison of Quality of Life, Cosmetic Outcomes and Overall Patient Satisfaction with Treatment

Abstract Background Our aim was to investigate whether the surgical approach, i.e. endoscopic (ET) versus conventional/open thyroidectomy (ConT), contributes towards the improvement in quality of life (QoL), cosmetic outcomes and overall patient satisfaction with treatment. Methods We conducted a prospective study (October 2016–August 2018) consisting of patients undergoing hemithyroidectomy for euthyroid, non‐malignant solitary thyroid nodules (STNs). Patients were divided into two groups: Group I (ET)—41 patients and Group II (ConT)—52 patients. ET was performed via bilateral‐axillo breast approach (BABA). A thyroid disease‐specific questionnaire “ThyPRO‐39hin” was used to evaluate pre‐ and post‐operative QoL. Visual analogue scale (VAS) was used for post‐operative pain. Cosmetic satisfaction, paraesthesia and overall satisfaction with treatment were evaluated using Likert‐type verbal response scales. Pre‐ and post‐operative scores (>6 months) were compared, and p value < 0.05 was considered significant. Results Mean age ( p = 0.26), gender distribution ( p = 0.07), mean tumour size ( p = 0.74) and preoperative scores of QoL were comparable between the two groups. Post‐operatively scores of symptom domain ( p = 0.03), tiredness ( p = 0.03), impaired social life ( p = 0.03), cosmetic complaints ( p = < 0.001) and overall QoL ( p = < 0.001) were significantly better in Group I. Also, post‐operative pain perception at first follow‐up visit ( p = 0.001) was lower in patients undergoing ET/Group I, with higher scar satisfaction scores ( p = < 0.001) and overall satisfaction with treatment ( p = < 0.001). Post‐operative paraesthesia perception was comparable ( p = 0.06) amongst the two groups. Conclusion In this cohort study, patients undergoing endoscopic thyroid surgery reported superior post‐operative QoL, cosmetic and overall satisfaction with treatment as compared to conventional/open thyroidectomy.