Preoperative scar perception study comparing ‘scarless’ in the neck endoscopic thyroidectomy with open thyroidectomy: a cross-sectional study

Abstract

Introduction Open thyroidectomy is the most common approach to thyroid surgery. However, ‘scarless’ (in the neck) endoscopic thyroidectomy, consisting of endoscopic and robotic surgery, is progressively being adopted for its perceived cosmetic benefits. This study aims to determine the patient’s preferred surgical approach and to identify the factors that influence their decision. Materials and methods A pilot study consisting of 100 patients with a surgical thyroid disorder were prospectively recruited from a single tertiary centre. An interviewer-administered survey was conducted. Demographic, socioeconomic status, scar perception and an adapted body image scale were evaluated to identify factors that shaped the patient’s perception of the surgical approach. Results The mean age of participants was 54.5 ± 13.0 years; 72% were women and 87% Chinese. Of the 100 patients, 75 patients considered scarless endoscopic thyroidectomy as their preferred surgical approach while 25 patients opted for open thyroid surgery. Improvement in scar perception score between scarless endoscopic thyroidectomy and open thyroid surgery is associated with an increased willingness to choose scarless endoscopic thyroidectomy. The mean body image scale score was 6.9 ± 2.8, indicating no statistical difference between the surgical approaches. On multivariate analysis, improvement in scar perception score (odds ratio 3.38, 95% confidence interval 1.11–10.29) and having surgeon recommendation (odds ratio 6.38, 95% confidence interval 1.80–22.63) were independently associated with interest in scarless endoscopic thyroidectomy. Conclusion Patients interest in undergoing scarless endoscopic thyroidectomy is driven by improved scar perception and surgeon’s recommendation compared with open thyroid surgery.

Patient Cosmetic Concerns Inform Decision-Making in Remote Access Thyroid Surgery

“…Centers that offer transoral thyroidectomy in communities with more varied demographics, lower socioeconomic status, or more elderly patients may find different preferences. Finally, surgeon recommendation for thyroidectomy approach was the strongest factor influencing patients' decisions, and many surgeons may be skeptical about the advantages of this newer technique (7). These factors may help explain the small percentage of U.S. patients currently opting for transoral thyroidectomy.…”

Advances in the assessment of cosmetic outcomes, sensory alteration in surgical areas, and health-related quality of life of endoscopic thyroidectomy

“…The choice between endoscopic and conventional thyroidectomy primarily hinges on several factors, including the patient’s desire for cosmetic results, quality of life considerations, and the recommendations of their surgeons. Additionally, patients often weigh other factors such as surgical risks, long-term complications, overall effectiveness, postoperative discomfort, and the associated expenses [ 9 – 13 ]. Numerous studies have provided evidence supporting the equivalency of endoscopic thyroidectomy conducted through various approaches, to open thyroidectomy in terms of feasibility, safety, and validity [ 5 , 14 – 17 ].…”

Conversion rates in robotic thyroid surgery: A systematic review and meta‐analysis

“…transoral, facelift, gasless transaxillary, retroauricolar, robotic‐assisted breast‐axillo insufflation thyroidectomy) hold significantly different conversion rates. Defining such risk of conversion appears pivotal, as the need for a neck incision for controlling the surgical field, despite not hindering the procedure outcomes, nullifies the major advantage of RATS, that is, the scarless or near‐scarless approach 10 …”

“…Defining such risk of conversion appears pivotal, as the need for a neck incision for controlling the surgical field, despite not hindering the procedure outcomes, nullifies the major advantage of RATS, i.e. the scarless or near-scarless approach 10 .…”

“…Defining such risk of conversion appears pivotal, as the need for a neck incision for controlling the surgical field, despite not hindering the procedure outcomes, nullifies the major advantage of RATS, that is, the scarless or near-scarless approach. 10 This systematic review and meta-analysis aims at delineating the risk of conversion in RATS and assessing whether specific subclasses of procedures or accesses should be regarded at higher risk.…”