Analysis of indicators of the postoperative period and quality of life after endoscopic hemithyreoidectomy using the axillary «gasless» approach and open hemithyroidectomy

Objective. To study the main indicators of the course of the postoperative period and the quality of life of patients after endoscopic hemithyroidectomy in comparison with hemithyroidectomy from the traditional open approach. Material and methods. The study is based on the analysis of postoperative outcomes and quality of life in 91 patients with benign thyroid nodules. The study group included 44 patients who underwent endoscopic hemithyroidectomy using a «gasless» axillary approach. The control group consisted of 47 patients who underwent hemithyroidectomy through the traditional approach. The results of the study were evaluated at checkpoints at 1 and 6 months after the intervention. Results. To evaluate the results, the level of pain syndrome was analyzed according to the visual analogue scale, the presence and severity of violations of the voice function and the act of swallowing, as well as the quality of life according to the SF-36 scale were studied. When assessing the severity of the pain syndrome, it was found that after endoscopic surgery, the intensity of pain above the clavicle was statistically significantly less in 12—48 hours after the intervention (p<0.05), and below the clavicle it turned out to be statistically significantly greater in the period of 12—96 hours after surgery (p<0.05). Regarding the frequency of development of violations of the voice function and the act of swallowing, its decrease was noted after endoscopic hemithyroidectomy. In particular, the reduction in the proportion of patients who reported discomfort when swallowing 1 month after surgery was statistically significant (13.6% vs. 36.2%; p<0.05). Patients who underwent endoscopic hemithyroidectomy also showed better results in a number of parameters of both physical and psychological components of health according to the SF-36 scale. Thus, 1 month after the operation, statistically significant differences were recorded in the criteria of Role-Physical Functioning (p<0.01), of Social Functioning (p<0.05) and of Role-Emotional Functioning (p<0.05). 6 months after the operation, all criteria of the physical component of health no longer showed significant differences between the comparison groups, but the differences associated with the psychological component remained in favor of endoscopic intervention. Conclusion. Endoscopic hemithyroidectomy through axillary «gasless» approach, compared with traditional open intervention, is characterized by a decrease in the incidence of such conditions as voice and swallowing disorders, and also improves the quality of life of patients both in the early and late postoperative period.