OBJECTIVE
To study and compare postoperative results, including the quality of life of patients after endoscopic hemithyroidectomy (EG) and minimally invasive video-assisted hemithyroidectomy (MIVAG).
MATERIAL AND METHODS
The study analyzed the postoperative results of surgical treatment of 89 patients who underwent hemithyroidectomy. The EG group consisted of 44 patients in whom the intervention was performed through an endoscopic «gasless» axillary approach. The MIVAG group included 45 patients operated on using a minimally invasive video-assisted cervical approach. In the early postoperative period, indicators of the level of pain syndrome were analyzed according to the visual analogue scale (VAS), and 1 and 6 months after the intervention, the severity and frequency of voice and swallowing disorders were assessed, as well as quality of life indicators according to the SF-36 scale.
RESULTS
When comparing the intensity of pain syndrome according to VAS, it was noted that the severity of pain in the anatomical regions above the clavicle was greater in patients in the MIVAG group during the first 60 hours after surgery, however, a statistically significant difference was noted only in the first 12 hours (p<0.05). In the areas below the clavicle, the intensity of the pain syndrome was statistically significantly higher in the EG group, while the differences were statistically significant (p<0.05) during the interval of 12—108 hours after the end of the operation. According to the total number of cases of dysphonia and dysphagia of varying severity, 1 and 6 months after surgery, the best results were demonstrated by patients in the EG group, but no statistically significant advantage was found. The assessment of the quality of life on the SF-36 scale 1 month after the operation showed that in the EG group, all indicators responsible for the psychological component of health were higher, and in the MIVAG group, on the contrary, the values of all criteria characterizing the physical component of health were higher. At the same time, the differences were statistically significant (p<0.05) in the criteria of Role-Emotional Functioning, and Physical Functioning. At the level of 6 months after the operation, there was basically an equalization of all indicators, however, there were still statistically significant differences (p<0.05) in favor of the EG group, associated with the indicator of Role-Emotional Functioning.
CONCLUSION
When comparing the postoperative results of EG and MIVAG, certain differences were revealed due to the technique and nature of the implementation of surgical manipulations, which, in turn, in both cases are fundamentally different from traditional interventions. In particular, EG compared with MIVAG allows to increase the values of the psychological component of the quality of life of patients in the early and late postoperative period, which is realized due to the translocation of the scar from the anterior surface of the neck to the axillary region. In turn, the performance of MIVAG is characterized by an increase in the values of the physical component of the quality of life in the early postoperative period due to a decrease in the overall trauma of surgical intervention.
