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Althoubaiti SA, Alharthi AS, Al Kahtani RM, Algrni MA, Alshorm AG, Mahfouz MEM. Post-thyroidectomy Depression and Associated Factors in Saudi Arabia. Cureus 2024; 16:e55328. [PMID: 38559523 PMCID: PMC10981879 DOI: 10.7759/cureus.55328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background Thyroidectomy is a common surgical procedure used to treat thyroid gland illnesses. The surgery has many outcomes, and one of them may show an association with depression. This study aims to assess the factors associated with depression after thyroidectomy in Saudi Arabia. Methodology A cross-sectional study was conducted among 414 Saudi participants. The target population included patients more than 18 years old and who had undergone thyroidectomy, whereas patients 18 years or younger were excluded. The data were collected between December 2023 and January 2024 using an electronic self-administered questionnaire that included demographics, clinical characteristics, and the nine-item Patient Health Questionnaire. The questionnaire was distributed randomly throughout social media, and patient consent was obtained. The descriptive and inferential analyses were performed using SPSS software version 27 (IBM Corp., Armonk, NY, USA). Results The study showed that of the 414 participants, 306 were females and 108 were males. Depression affected 335 (80.92%) participants and was mostly mild (120, 28.99%), followed by moderate (109, 26.33%), moderately severe (55, 13.29%), and severe (51, 12.32%). Depression symptoms were more common in females than males. The participants who underwent total thyroidectomy (217, 52.41%) were more than those who underwent partial thyroidectomy (197, 47.58%). Temporary complications were more prevalent in the participants exhibiting symptoms of depression. Both educational level and surgery time were significant factors. Conclusions The study revealed a significant prevalence of post-thyroidectomy depression. The associated factors in post-thyroidectomy depression included educational level, with more depression symptoms noted with high education. In addition, surgery time showed an increased risk of developing depression that still existed two years postoperatively.
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Affiliation(s)
| | - Amirah S Alharthi
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | | | - Mayar A Algrni
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | - Amal G Alshorm
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
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de Koster EJ, Husson O, van Dam EWCM, Mijnhout GS, Netea-Maier RT, Oyen WJG, Snel M, de Geus-Oei LF, Vriens D. Health-related quality of life following FDG-PET/CT for cytological indeterminate thyroid nodules. Endocr Connect 2022; 11:EC-22-0014. [PMID: 35731242 PMCID: PMC9346328 DOI: 10.1530/ec-22-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study assessed the health-related quality of life (HRQoL) in patients undergoing 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-PET/CT for an indeterminate (Bethesda III/IV) thyroid nodule. FDG-PET/CT accurately rules out malignancy and prevents 40% of futile diagnostic surgeries in these nodules. DESIGN Secondary analyses of HRQoL data from a randomised controlled multicentre trial (NCT02208544) in 126 patients from 15 hospitals in the Netherlands were done. METHODS Longitudinal HRQoL assessment was performed using the EuroQol 5-dimension 5-level (EQ-5D-5L), the RAND 36-item Health Survey v2.0 (RAND-36), and the Thyroid Patient-Reported Outcome (ThyPRO) questionnaire on baseline, 3, 6, and 12 months, relative to the date of the FDG-PET/CT scan. RESULTS Patients who were randomised to active surveillance following an FDG-negative nodule instead of diagnostic surgery reported stable HRQoL scores throughout the year. Univariate analysis indicated better HRQoL for patients undergoing surveillance than surgical patients with benign histopathology on multiple physical and psychosocial domains. Univariate within-group analysis suggested both temporary and continued HRQoL deteriorations in patients with benign histopathology over time. Multivariate within-group analysis demonstrated no significant longitudinal HRQoL changes in patients undergoing active surveillance. In contrast, in patients with benign histopathology, worse HRQoL was observed with regard to ThyPRO cognitive impairment (P = 0.01) and cosmetic complaints (P = 0.02), whereas goitre symptoms (P < 0.001) and anxiety (P = 0.04) improved over time. In patients with malignant histopathology, anxiety also decreased (P = 0.05). CONCLUSIONS The reassurance of a negative FDG-PET/CT resulted in sustained HRQoL throughout the first year of active surveillance. Diagnostic surgery for a nodule with benign histopathology resulted in more cognitive impairment and physical problems including cosmetic complaints, but improved goitre symptoms and anxiety. Anxiety was also reduced in patients with malignant histopathology.
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Affiliation(s)
- Elizabeth J de Koster
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Clinical Studies, Institute of Cancer Research, London, UK
- Correspondence should be addressed to O Husson:
| | - Eveline W C M van Dam
- Department of Internal Medicine, Division of Endocrinology, location VU University Medical Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - G Sophie Mijnhout
- Department of Internal Medicine, Isala Hospital, Zwolle, The Netherlands
| | - Romana T Netea-Maier
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wim J G Oyen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Biomedical Sciences and Humanitas Clinical and Research Centre, Department of Nuclear Medicine, Humanitas University, Milan, Italy
| | - Marieke Snel
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Dennis Vriens
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
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de Oliveira GB, de Oliveira TJ, Santos MHDS, Rocha RM, Guimarães MF, Azevedo EHM. Voice-related quality of life and emotional symptoms before and after thyroidectomy. Codas 2022; 34:e20210118. [PMID: 35137894 PMCID: PMC9886117 DOI: 10.1590/2317-1782/20212021118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/29/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To correlate voice-related quality of life, anxiety, and depression symptoms pre- and post-thyroidectomy. METHODS Observational, longitudinal, prospective, and quantitative study. Twenty patients participated in the study, with a mean age of 54 years, who underwent thyroidectomy, laryngeal visual examination, and the Voice-Related Quality of Life and Hospital Anxiety and Depression Scale questionnaires at different times: preoperative, 1 week and 3 months post-thyroidectomy, with a higher prevalence of females (85%; n=17) and partial thyroidectomy (70%; n=14). RESULTS There was no statistical difference in voice quality of life between the moments, but lower preoperative scores were observed, especially in the physical domain. We observed a slight trace of anxiety in the preoperative period, with a reduction after 1 week and an increase after 3 months. There was a moderate negative correlation between the physical domain of QVV and the anxiety subscale and the total HADS score after 1 week and between the total domain of QVV with the total HADS score after 1 week, weak negative correlation between the total domain of QVV and the HADS anxiety subscale after 1 week and the total HADS score after 3 months. CONCLUSION The patients evaluated in this study self-perceived their voice-related quality of life as positive. Mild anxiety traits were identified, with a reduction after one week postoperatively and an increase after three months. The self-perception of better voice-related quality of life in the postoperative period is weakly related to the reduction of anxiety levels.
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Affiliation(s)
| | - Thais Jejesky de Oliveira
- Departamento de Fonoaudiologia, Universidade Federal do Espírito Santo – UFES - Vitória (ES), Brasil.
| | | | - Ricardo Mai Rocha
- Hospital Universitário Cassiano Antônio Moraes – EBSERH - Vitória (ES), Brasil.,Departamento de Cirurgia de Cabeça e Pescoço, Universidade Federal do Espírito Santo – UFES - Vitória (ES), Brasil.
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Azaria S, Cherian AJ, Gowri M, Thomas S, Gaikwad P, Mj P, Abraham DT. Impact of thyroidectomy on quality of life in benign goitres: results from a prospective cohort study. Langenbecks Arch Surg 2022; 407:1193-1199. [PMID: 34988642 DOI: 10.1007/s00423-021-02391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Benign thyroid diseases encompass a large spectrum of conditions that are chronic and subtle in nature. A majority of patients choose non-surgical management and continue living their daily lives with subconscious impairment of optimal functioning. We studied the effect of thyroidectomy on the quality of life (QoL) in patients with benign goitres. METHODS A prospective study was conducted on 50 patients between January 2017 and August 2018 using the ThyPRO 39 questionnaire. This is a disease-specific health-related questionnaire administered the day before surgery and 6 months following surgery. Data analysis was performed using EpiData Manager and EpiData Entry Client (v 3.1). RESULTS The mean age of the cohort was 43.30 years ± 11.61, with a female preponderance (34:16). The most common indications for surgery were suspicion of malignancy and compressive symptoms in 34% and 30%, respectively. The most common histopathology reported was nodular/adenomatous hyperplasia (56%). Prior to surgery, the most common domains affected were emotional susceptibility and tiredness. Following surgery, a significant improvement in all domains of the ThyPRO 39 questionnaire were seen except for psychological well-being (p=0.126). In addition, the composite scores significantly improved (p<0.001). Younger age, female gender, and longer duration of goitre were the factors that significantly affected the outcomes in various domains. CONCLUSION Patients with benign goitres have subtle impairment of QoL which showed significant improvement following thyroidectomy.
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Affiliation(s)
- Swarna Azaria
- Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Anish Jacob Cherian
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Shawn Thomas
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Pranay Gaikwad
- Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Paul Mj
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Deepak Thomas Abraham
- Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
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Dionisi-Vici M, Fantoni M, Botto R, Nervo A, Felicetti F, Rossetto R, Gallo M, Arvat E, Torta R, Leombruni P. Distress, anxiety, depression and unmet needs in thyroid cancer survivors: a longitudinal study. Endocrine 2021; 74:603-610. [PMID: 34143334 PMCID: PMC8571224 DOI: 10.1007/s12020-021-02786-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/03/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Despite a good prognosis, thyroid cancer (TC) survivors often report psychological distress and decreased quality of life. This longitudinal study aims to evaluate TC survivors' levels of distress, anxiety, depression and unmet needs, checking potential life events. METHODS Distress Thermometer, Hospital Anxiety Depression Scale, Supportive Care Need Survey (short form) and Interview for Recent Life Events were administered to 73 TC survivors (T0) and 44 of them were re-tested one year later (T1). Participants were at 0-5, 5-10 or >10 years from the end of their cancer-related treatments. RESULTS At T0, distress, anxiety and depression mean scores were 6.4, 6.8 and 5.3, while at T1 they were 5.5, 4.8 and 5.1. Only anxiety scores decreased significantly between T0 and T1. 50.7% of patients had unmet psychological needs at T0 and 50.0% at T1. Most participants were satisfied in the communicative/ informative (T0:79.5%; T1: 77.3%) and social/health care areas (T0:74.0%; T1:75.0%). The most experienced stressful events detected concerned their working areas. CONCLUSIONS Results confirmed that patients reported distress, anxiety and depression concerns even many years after the end of treatments. Both medical and psychological surveillance are relevant to improving TC survivors' wellbeing.
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Affiliation(s)
- Margherita Dionisi-Vici
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | | | - Rossana Botto
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy.
| | - Alice Nervo
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Ruth Rossetto
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Marco Gallo
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Emanuela Arvat
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Paolo Leombruni
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
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Song CM, Bang HS, Kim HG, Park HJ, Tae K. Health-related quality of life after transoral robotic thyroidectomy in papillary thyroid carcinoma. Surgery 2021; 170:99-105. [PMID: 33773821 DOI: 10.1016/j.surg.2021.02.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health-related quality of life after transoral robotic thyroidectomy has not been evaluated thoroughly. The purpose of this study was to compare health-related quality of life after transoral robotic thyroidectomy and after conventional thyroidectomy. METHODS This study is a prospective, cross-sectional, and observational study of 114 patients who underwent transoral robotic thyroidectomy (57 patients) or conventional transcervical thyroidectomy (57 patients) for the treatment of papillary carcinoma. We used 2 questionnaires: the University of Washington Quality of Life questionnaire for head and neck cancer and the thyroid cancer-specific Quality of Life questionnaire (Thyroid Version). The survey was performed preoperatively, and 3 months and 1 year after thyroidectomy. RESULTS Mean scores for neck appearance were higher after surgery in the transoral robotic thyroidectomy group than the conventional group at both 3 months and 1 year. Anxiety was significantly improved after surgery in both groups. Total scores for health-related quality of life after surgery were similar in both groups. Health-related quality of life and overall quality of life over the previous 7 days as measured by the University of Washington Quality of Life questionnaire were significantly better at 1 year than in the preoperative period in both groups. Before surgery, patients in the both groups regarded anxiety and mood as the most important aspects of health-related quality of life. After surgery, patients in the transoral robotic thyroidectomy group identified anxiety, mood, and speech as the most significant issues, while patients in the conventional group selected anxiety, mood, and neck appearance. CONCLUSION Quality of life related to neck appearance is higher after transoral robotic thyroidectomy than after transcervical thyroidectomy. However, total scores for health-related quality of life did not differ in the 2 groups after surgery.
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Affiliation(s)
- Chang Myeon Song
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyang Sook Bang
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyung Gu Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hae Jin Park
- Department of Radiation Oncology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Kyung Tae
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
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Moon JH, Ryu CH, Cho SW, Choi JY, Chung EJ, Hah JH, Hwangbo Y, Jeong WJ, Jung YS, Kim JH, Kim MJ, Kim SJ, Kim YK, Lee CY, Lee EK, Lee JY, Lee KE, Lee YJ, Lee Y, Yu HW, Park DJ, Ryu J, Park YJ. Effect of Initial Treatment Choice on 2-year Quality of Life in Patients with Low-risk Papillary Thyroid Microcarcinoma. J Clin Endocrinol Metab 2021; 106:724-735. [PMID: 33248442 DOI: 10.1210/clinem/dgaa889] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT The long-term quality of life (QoL) in patients with low-risk papillary thyroid microcarcinoma (PTMC) underwent active surveillance (AS) and immediate surgery is unclear. OBJECTIVE The aim of this study was to investigate the effect of initial treatment choice on 2-year QoL in patients with low-risk PTMC. DESIGN, SETTING, AND PARTICIPANTS We analyzed 2652 QoL surveys from 1055 subjects enrolled in ongoing multicenter prospective cohort study on active surveillance of PTMC, in which the median follow-up duration was 24.4 months. MAJOR OUTCOME MEASURE We evaluated QoL of patients with low-risk PTMC according to their treatment modality using generalized estimating equation. RESULTS Six hundred and seventy-four subjects (male = 161; mean age = 48.8 ± 11.9 years) with low-risk PTMC chose AS while 381 subjects (male = 75; mean age = 45.7 ± 10.4 years) chose immediate surgery, including lobectomy/isthmusectomy (L/I) and total thyroidectomy (TT). Among the 817 subjects who completed baseline QoL surveys, 2-year QoL was good in order of AS (n = 500), L/I (n = 238), and TT (n = 79) groups after adjustment for age, sex, baseline tumor size, and baseline QoL scores. Among the 101 subjects who changed their treatment from AS to surgery during the follow-up period, 35 subjects who changed treatment due to disease progression had better QoL than 66 subjects who had no disease progression. CONCLUSIONS This study identified QoL as a major issue in choosing an initial treatment of low-risk PTMC and highlighted the possibility of using AS as the primary treatment.
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Affiliation(s)
- Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Republic of Korea
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology, National Cancer Center, Goyang, Republic of Korea
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Sun Wook Cho
- Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Republic of Korea
| | - Eun-Jae Chung
- Department of Otorhinolaryngology, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Jeong Hun Hah
- Department of Otorhinolaryngology, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Yul Hwangbo
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Republic of Korea
| | - Yuh-Seog Jung
- Department of Otorhinolaryngology, National Cancer Center, Goyang, Republic of Korea
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Min Joo Kim
- Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Su-Jin Kim
- Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Yeo Koon Kim
- Department of Radiology, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Republic of Korea
| | - Chang Yoon Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
- Department of Radiology, National Cancer Center, Goyang, Republic of Korea
| | - Eun Kyung Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Ji Ye Lee
- Department of Radiology, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - You Jin Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Yumi Lee
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Hyeong Won Yu
- Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Republic of Korea
| | - Do Joon Park
- Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
| | - Junsun Ryu
- Department of Otorhinolaryngology, National Cancer Center, Goyang, Republic of Korea
- Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
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Quality of life and surgical outcome of ABBA versus EndoCATS endoscopic thyroid surgery: a single center experience. Surg Endosc 2021; 36:968-979. [PMID: 33683436 PMCID: PMC8758646 DOI: 10.1007/s00464-021-08361-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 02/09/2021] [Indexed: 12/02/2022]
Abstract
Background Thyroid surgery is often performed, especially in young female patients. As patient satisfaction become more and more important, different extra-cervical “remote” approaches have evolved to avoid visible scars in the neck for better cosmetic outcome. The most common remote approaches are the transaxillary and retroauricular. Aim of this work is to compare Endoscopic Cephalic Access Thyroid Surgery (EndoCATS) and axillo-bilateral-breast approach (ABBA) to standard open procedures regarding perioperative outcome and in addition to control cohorts regarding quality of life (QoL) and patient satisfaction. Methods In a single center, 59 EndoCATS und 52 ABBA procedures were included out of a 2 years period and compared to 225 open procedures using propensity-score matching. For the endoscopic procedures, cosmetic outcome, patient satisfaction and QoL (SF-12 questionnaire) were examined in prospective follow-up. For QoL a German standard cohort and non-surgically patients with thyroid disease were used as controls. Result The overall perioperative outcome was similar for all endoscopic compared to open thyroid surgeries. Surgical time was longer for endoscopic procedures. There were no cases of permanent hypoparathyroidism and no significant differences regarding temporary or permanent recurrent laryngeal nerve (RLN) palsies between open and ABBA or EndoCATS procedures (χ2; p = 0.893 and 0.840). For ABBA and EndoCATS, 89.6% and 94.2% of patients were satisfied with the surgical procedure. Regarding QoL, there was an overall significant difference in distribution for physical, but not for mental health between groups (p < 0.001 and 0.658). Both endoscopic groups performed slightly worse regarding physical health, but without significant difference between the individual groups in post hoc multiple comparison. Conclusion Endoscopic thyroid surgery is safe with comparable perioperative outcome in experienced high-volume centers. Patient satisfaction and cosmetic results are excellent; QoL is impaired in surgical patients, as they perform slightly worse compared to German standard cohort and non-surgical patients.
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Choi KW, Kim Y, Fava M, Mischoulon D, Na EJ, Kim SW, Shin MH, Chung MK, Jeon HJ. Increased Morbidity of Major Depressive Disorder After Thyroidectomy: A Nationwide Population-Based Study in South Korea. Thyroid 2019; 29:1713-1722. [PMID: 31422760 DOI: 10.1089/thy.2019.0091] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: The number of thyroidectomies in South Korea has been increasing rapidly due to extensive checkups for thyroid cancer. However, few studies have examined the association between thyroidectomy and major depressive disorder (MDD). We investigated the association between thyroidectomy and the risk of MDD. Methods: A population-based electronic medical records database from South Korea was used to identify 187,176 individuals who underwent partial or total thyroidectomy between 2009 and 2016. A self-controlled case series design and Cox regression analyses were used to identify risk factors for MDD. Results: Among the 187,176 individuals who underwent thyroidectomy, 16,744 (8.9%) were diagnosed with MDD during the observation period. Of those, 3837 (22.9%) underwent partial thyroidectomy and 12,907 (77.1%) underwent total thyroidectomy. An elevated MDD risk was found during the one-year period before thyroidectomy, with incidence rate ratios (IRRs) of 1.29 ([95% confidence interval [CI] 1.18-1.41], p < 0.0001) for subjects with partial thyroidectomy and 1.27 ([95% CI 1.21-1.33], p < 0.0001) for subjects with total thyroidectomy. After total thyroidectomy, the IRR increased for 31-60 days (IRR 1.81; [95% CI 1.59-2.06], p < 0.0001) and remained elevated for up to 540 days, whereas after partial thyroidectomy, the IRR increased for 31-60 days (IRR 1.68; [95% CI 1.32-2.13], p < 0.0001) but returned to baseline levels after 270 days. Total thyroidectomy was associated with a prolonged risk of MDD compared with partial thyroidectomy in patients with cancer, which was different from the results in patients without cancer. Conclusion: The incidence of MDD increased in the period immediately after thyroidectomy and remained high for one to two years. This study highlights the importance of relatively long-term regular psychiatric assessments in patients who undergo partial or total thyroidectomy.
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Affiliation(s)
- Kwan Woo Choi
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yuwon Kim
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine Seoul, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Eun Jin Na
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Korean Psychological Autopsy Center (KPAC), Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine Seoul, South Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Head and Neck Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Korean Psychological Autopsy Center (KPAC), Seoul, Korea
- Department of Health Sciences & Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Department of Medical Device Management & Research, and Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
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10
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Minuto MN, Reina S, Monti E, Ansaldo GL, Varaldo E. Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients. J Endocrinol Invest 2019; 42:1291-1297. [PMID: 31124043 DOI: 10.1007/s40618-019-01064-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/14/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE The endocrine surgeon and the endocrinologist should standardize how they deal with patients with an indication for thyroidectomy, as the road to surgery starts well before the operation itself. The patient should be thoroughly informed about where and how surgery will be performed, the postoperative improvements that can be expected, and the possibility and incidence of relevant complications. This short review aims at identifying the most common postoperative issues after thyroidectomy, with the relevant therapeutic suggestions. METHODS A revision of studies reporting the morbidity of thyroid surgery, involving the largest numbers of patients. RESULTS It has been clearly demonstrated that the outcome of thyroid surgery is significantly better when the procedure is performed by an experienced surgeon. Thus, the number of thyroidectomies performed by a surgeon should drive the endocrinologist when referring a patient. CONCLUSIONS Despite the surgeon's experience, thyroidectomy is burdened by a relatively high rate of postoperative issues ranging from less severe ones to others causing significant changes in the patient's quality of life. Minor, non-invalidating symptoms have been described in 40% of patients after thyroidectomy (e.g. hoarseness, mild dysphagia, some degree of voice alteration); however, these symptoms usually resolve within a few months of surgery, with or without early treatment. On the other hand, major postoperative complications are observed in a limited number of patients, but in these cases early diagnosis is important to provide the most appropriate postoperative treatment, and thus hasten full recovery or at least achieve the greatest possible improvement.
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Affiliation(s)
- M N Minuto
- Dipartimento di Scienze Chirurgiche (DISC), Università degli Studi di Genova, V.le Benedetto XV 6, 16132, Genoa, Italy.
- U.O. Chirurgia 1, Dipartimento di Chirurgia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - S Reina
- Dipartimento di Scienze Chirurgiche (DISC), Università degli Studi di Genova, V.le Benedetto XV 6, 16132, Genoa, Italy
- U.O. Chirurgia 1, Dipartimento di Chirurgia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - E Monti
- Dipartimento di Medicina Interna (DIMI), Università degli Studi di Genova, Genoa, Italy
| | - G L Ansaldo
- U.O. Chirurgia 1, Dipartimento di Chirurgia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - E Varaldo
- Dipartimento di Scienze Chirurgiche (DISC), Università degli Studi di Genova, V.le Benedetto XV 6, 16132, Genoa, Italy
- U.O. Chirurgia 1, Dipartimento di Chirurgia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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