EXPLORING PSYCHOPHYSICAL AND SOCIAL EFFECTS OF THYROID SURGERY: COULD PATIENT'S EMOTIONAL EXPERIENCE HELP US CHOOSING THE SURGICAL APPROACH?

AUTHORS:
R. Melcarne (Rome, Italy) , M. Biffoni (Rome, Italy) , G. Grani (Rome, Italy) , L. Landi (Rome, Italy) , G. De Ruggieri (Rome, Italy) , A. Galvano (Rome, Italy) , M. Mohammad Hosseinpour Razlighi (Rome, Italy) , E. Iannuzzi (Rome, Italy) , S. Lotito (Rome, Italy) , F. Consorti (Rome, Italy) , C. Durante (Rome, Italy) , L. Giacomelli (Rome, Italy)
Background:
Differentiated thyroid carcinoma is an increasingly common cancer; its excellent prognosis and the most affected age group (under 40), require paying attention to the well-being of patients during postoperative period. In fact, possible post-surgical complications, the need to undertake long-term treatment and living with a diagnosis of malignancy can have a considerable impact on patients' well-being. The objective of this study is to elucidate whether there are any significant differences in the state of health of patients undergoing a total versus a hemithyroidectomy, in purpose, cases of non-universality of indications, improve doctor-patient communication and provide additional decision-making knowledge.
Methods:
The study included patients undergoing thyroid surgery with at least 1 year of follow-up. Patients selected by application of specific inclusion criteria received questionnaires (THYCA-QoL; BMQ, ASC). Based on the data obtained from the comparison between the two samples, an additional oral survey of patients' emotional experience was conducted with the aim of developing a more in-depth interpretation of the results.
Results:
Significant differences between the two groups were recorded on issues related to surgical scar (p=0.0007), weight gain (p=0.021), higher anxiety (p=0.008), paresthesias (p=0.04) and perceived dependence on medication (p=0.011). Patients undergoing total thyroidectomy are disadvantaged in postoperative well-being. Interpretive analysis of data demonstrates a certain association with postoperative phase of drug dosage adjustment.
Conclusions:
In the absence of clear indications, it would be preferable to orient the choice of a less demolishing surgical therapy, in order to achieve a good psychophysical state of the patient and try to avoid drug treatment.