Search

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. Presentations: Part of this study was presented as oral presentation during World Congress of Endoscopic Surgery, September 2022, Busan, KoreaPart of this study was presented as oral presentation and was awarded Dr C Palanivelu Best Paper Award during annual meeting of the Association of Surgeons of India (ASICON), December 2022, Mumbai, IndiaPart of this study was presented as travel award presentation during annual meeting of the Korean Society of Endoscopic and Robotic Surgery, April 2023, Seoul, Korea [ABSTRACT FROM AUTHOR]