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<p>Endoscopic thyroid surgery provides a favorable cosmetic outcome; however, it may induce more trauma than that caused by conventional open thyroidectomy. In this context, the present study aimed to explore the quality of life (QOL) of patients undergoing endoscopic thyroid cancer surgery through the trans-breast approach based on patient-reported quality of recovery by using the Quality of Recovery-40 (QoR-40) questionnaire. This study included patients in our hospital who were scheduled to undergo thyroid cancer surgery. Based on the chosen surgical methods, these patients were classified into two groups: the total endoscopic thyroidectomy (TET) group and the conventional open thyroidectomy (COT) group. The TET group received endoscopic thyroid cancer surgery through the trans-breast approach, while the COT group underwent conventional open thyroidectomy. Using the QoR-40 questionnaire, patient-reported quality of recovery was recorded daily from 1&#xa0;day before the surgery to 1 week after the surgery. Based on the QoR-40 scores, the differences in the QOL of the two groups were compared from the perspective of patients’ subjective perceptions by repeated measures analysis of variance (ANOVA). The TET and COT groups showed no significant difference in demographic and perioperative data. The TET group had longer operation time (206.50 ± 44.61&#xa0;min) than the COT group (130.07 ± 33.74&#xa0;min; <i>p</i> &lt; 0.001). Both groups showed no significant differences in intraoperative blood loss and drain removal time (both <i>p</i> &gt; 0.05). The first day postoperative drainage after surgery in the TET group was 63.70 ± 33.41 mL, which was more than that in the COT group (28.35 ± 22.42 mL; <i>p</i> &lt; 0.001). Both groups showed no significant difference in the postoperative drainage on the second and third days after surgery (both <i>p</i> &gt; 0.05). Although the number of retrieved lymph nodes was less in the TET group than in the COT group (<i>p</i> = 0.002), both groups showed no significant difference in the number of metastatic lymph nodes (<i>p</i> = 0.363). Moreover, the incidence of postoperative complications and the postoperative hospital stay time were not significantly different between the two groups (both <i>p</i> &gt; 0.05). The total hospitalization cost of the TET group was higher than that of the COT group (<i>p</i> &lt; 0.001). The QoR-40 scores of the TET and COT groups at the baseline were 188.83 ± 10.87 and 186.18 ± 14.90, respectively, with no significant difference (<i>p</i> = 0.341). Repeated measures ANOVA revealed no significant difference in the QoR-40 scores at multiple timepoints between the TET and COT groups (<i>p</i> = 0.586). Individual analysis of each dimension based on repeated measures ANOVA showed significant differences in the QoR-40 scores at multiple timepoints between the TET and COT groups in the “Pain” dimension (<i>p</i> = 0.018), while the other dimensions showed no significant differences (all <i>p</i> &gt; 0.05). Objective evidence suggests that the safety and efficacy of endoscopic thyroid cancer surgery through the trans-breast approach are similar to those of conventional open thyroidectomy. According to patient-reported quality of recovery, our findings suggest that the two surgical methods are associated with comparable short-term recovery overall, with a possible advantage of endoscopic thyroid surgery in the pain domain.</p>

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Application of the quality of recovery-40 questionnaire to evaluate the patient-reported quality of recovery of thyroid cancer patients undergoing endoscopic surgery through the trans-breast approach

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  • 发表日期：

    2026年8月3日

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  • Zhijun Zhu,
  • Shuang Feng,
  • Yue Feng,
  • Lan Liang,
  • Yan Wen,
  • Li Lin,
  • Shipeng Wu,
  • Hongpei Liang,
  • Yeyang Chen

摘要

Endoscopic thyroid surgery provides a favorable cosmetic outcome; however, it may induce more trauma than that caused by conventional open thyroidectomy. In this context, the present study aimed to explore the quality of life (QOL) of patients undergoing endoscopic thyroid cancer surgery through the trans-breast approach based on patient-reported quality of recovery by using the Quality of Recovery-40 (QoR-40) questionnaire. This study included patients in our hospital who were scheduled to undergo thyroid cancer surgery. Based on the chosen surgical methods, these patients were classified into two groups: the total endoscopic thyroidectomy (TET) group and the conventional open thyroidectomy (COT) group. The TET group received endoscopic thyroid cancer surgery through the trans-breast approach, while the COT group underwent conventional open thyroidectomy. Using the QoR-40 questionnaire, patient-reported quality of recovery was recorded daily from 1 day before the surgery to 1 week after the surgery. Based on the QoR-40 scores, the differences in the QOL of the two groups were compared from the perspective of patients’ subjective perceptions by repeated measures analysis of variance (ANOVA). The TET and COT groups showed no significant difference in demographic and perioperative data. The TET group had longer operation time (206.50 ± 44.61 min) than the COT group (130.07 ± 33.74 min; p < 0.001). Both groups showed no significant differences in intraoperative blood loss and drain removal time (both p > 0.05). The first day postoperative drainage after surgery in the TET group was 63.70 ± 33.41 mL, which was more than that in the COT group (28.35 ± 22.42 mL; p < 0.001). Both groups showed no significant difference in the postoperative drainage on the second and third days after surgery (both p > 0.05). Although the number of retrieved lymph nodes was less in the TET group than in the COT group (p = 0.002), both groups showed no significant difference in the number of metastatic lymph nodes (p = 0.363). Moreover, the incidence of postoperative complications and the postoperative hospital stay time were not significantly different between the two groups (both p > 0.05). The total hospitalization cost of the TET group was higher than that of the COT group (p < 0.001). The QoR-40 scores of the TET and COT groups at the baseline were 188.83 ± 10.87 and 186.18 ± 14.90, respectively, with no significant difference (p = 0.341). Repeated measures ANOVA revealed no significant difference in the QoR-40 scores at multiple timepoints between the TET and COT groups (p = 0.586). Individual analysis of each dimension based on repeated measures ANOVA showed significant differences in the QoR-40 scores at multiple timepoints between the TET and COT groups in the “Pain” dimension (p = 0.018), while the other dimensions showed no significant differences (all p > 0.05). Objective evidence suggests that the safety and efficacy of endoscopic thyroid cancer surgery through the trans-breast approach are similar to those of conventional open thyroidectomy. According to patient-reported quality of recovery, our findings suggest that the two surgical methods are associated with comparable short-term recovery overall, with a possible advantage of endoscopic thyroid surgery in the pain domain.