Avaliação da qualidade de vida dos pacientes submetidos à tireoidectomia parcial e total
Quality of life assessment in patients undergoing partial and total thyroidectomy
Pedro Henrique Serra Carvalho dos Santos; Roberta Zambo Galafassi; Giulia Fernandes Manhães Rodrigues Lopes; Leiziane Assunção Alves Guimarães; Fatima Rosalia Hartelsberger Bobadilla; Inês Nobuko Nishimoto; Rogério Aparecido Dedivitis
Resumo
Objetivo: A tireoidectomia, remoção parcial ou total da glândula tireoide, é uma cirurgia comumente realizada para diversas doenças da tireoide. Recentemente, tem-se observado uma tendência pelo uso de tireoidectomias parciais, devido às taxas de complicações mais baixas e resultados terapêuticos adequados.
Objetivo: Avaliar o impacto da tireoidectomia parcial e total na qualidade de vida.
Métodos: O questionário ThyPRO-39 foi utilizado para avaliar os resultados específicos de qualidade de vida relacionados à tireoide em pacientes que se submeteram a diferentes abordagens de tireoidectomia.
Resultados: As complicações pós-operatórias foram paralisia unilateral transitória do nervo recorrente (6,5%) e hipoparatireoidismo transitório (22,4%). Os resultados de qualidade de vida após a tireoidectomia foram favoráveis. A extensão da tireoidectomia não apresentou diferença estatística (p = 0,982). Escores significativamente mais baixos foram associados ao gênero feminino e ao esvaziamento cervical.
Conclusão: Os escores de qualidade de vida foram elevados, com escores mais baixos entre as mulheres e na presença de esvaziamento cervical.
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References
1 Dent P, Kumar A. Thyroidectomy Surgery Oxford. 2024;42(4):246-251. doi: 10.1016/j.mpsur.2024.01.001
2 Scott B, Wong RJ. Step-by-Step Thyroidectomy-Incision, Nerve Identification, Parathyroid Preservation, and Gland Removal. Otolaryngol Clin North Am. 2024 Feb;57(1):25-37. doi: 10.1016/j.otc.2023.08.007. Epub 2023 Sep 23. PMID: 37748983.
3 Marciniak C, Lenne X, Clément G, Bruandet A, Lifante JC, Sebag F, Mirallié E, Mathonnet M, Brunaud L, Donatini G, Tresallet C, Ménégaux F, Theis D, Pattou F, Caiazzo R; on the behalf of AFCE Study Group. Partial Versus Total Thyroidectomy: What Influences Most Surgeons' Decision? Analysis of a Nationwide Cohort of 375,810 Patients Over 10 Years. Ann Surg. 2021 Nov 1;274(5):829-835. doi: 10.1097/SLA.0000000000005134. PMID: 34353991.
4 Baral S, Borgohain R, Timungpi G. Complications of thyroidectomy: Insights from a single-centre study in northeast India. J Otorhinolaryngol Allied Sci. 2023;6(4):113-118. doi: 10.18231/j.ijoas.2023.026
5 Daba SA, Teklewold B, Suga Y, Biratu TD, Hassen IK. Post-Thyroidectomy Complications at St Paul's Hospital Millennium Medical College, Ethiopia: Associated Factors and Outcomes', Open Access Surg. 2023;16:77-86. doi: 10.2147/OAS.S428155.
6 Boronat M, González-Lleó A, Rodríguez-Pérez C, Feldt-Rasmussen U, López-Plasencia Y, Rasmussen ÅK, Alberiche-Ruano MP, Hegedüs L, Alvarado-Martel D, Bonnema SJ, Marrero-Arencibia D, Groenvold M, Bjorner JB, Watt T. Adaptation and cross-cultural validation of the Spanish version of the Thyroid-Related Quality-of-Life Patient-Reported Outcome questionnaire. Endocrinol Diabetes Nutr (Engl Ed). 2018 Nov;65(9):500-507. English, Spanish. doi: 10.1016/j.endinu.2018.06.010. Epub 2018 Aug 17. PMID: 30126798.
7 Watt T, Hegedüs L, Rasmussen AK, Groenvold M, Bonnema SJ, Bjorner JB, Feldt-Rasmussen U. Which domains of thyroid-related quality of life are most relevant? Patients and clinicians provide complementary perspectives. Thyroid. 2007 Jul;17(7):647-54. doi: 10.1089/thy.2007.0069. PMID: 17696835.
8 Watt T, Rasmussen AK, Groenvold M, Bjorner JB, Watt SH, Bonnema SJ, Hegedüs L, Feldt-Rasmussen U. Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing. Qual Life Res. 2008 Sep;17(7):1009-17. doi: 10.1007/s11136-008-9364-z. Epub 2008 Jun 27. Erratum in: Qual Life Res. 2008 Sep;17(7):1019. PMID: 18584308.
9 Watt T, Bjorner JB, Groenvold M, Rasmussen AK, Bonnema SJ, Hegedüs L, Feldt-Rasmussen U. Establishing construct validity for the thyroid-specific patient reported outcome measure (ThyPRO): an initial examination. Qual Life Res. 2009 May;18(4):483-96. doi: 10.1007/s11136-009-9460-8. Epub 2009 Mar 14. PMID: 19288224.
10 Watt T, Hegedüs L, Groenvold M, Bjorner JB, Rasmussen AK, Bonnema SJ, Feldt-Rasmussen U. Validity and reliability of the novel thyroid-specific quality of life questionnaire, ThyPRO. Eur J Endocrinol. 2010 Jan;162(1):161-7. doi: 10.1530/EJE-09-0521. Epub 2009 Oct 1. PMID: 19797502.
11 Watt T, Bjorner JB, Groenvold M, Cramon P, Winther KH, Hegedüs L, Bonnema SJ, Rasmussen ÅK, Ware JE Jr, Feldt-Rasmussen U. Development of a Short Version of the Thyroid-Related Patient-Reported Outcome ThyPRO. Thyroid. 2015 Oct;25(10):1069-79. doi: 10.1089/thy.2015.0209. Epub 2015 Aug 26. PMID: 26214034.
12 Freitas JC. Validação do questionário thypro-39br e desenvolvimento de aplicativo para avaliar a qualidade de vida em pacientes com doenças da tireoide. 2021. 82 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas). Ceará: Universidade Federal do Ceará, 2021.
13 Dwivedi S, Kumar S, Saxena V, Dutta A, Dinker Y, Dwivedi S, Majumdar SS, Varshaney A, Sharma M. Evaluation of Scar Cosmesis and Quality of Life After Thyroid Surgery: A Retrospective Study. Indian J Otolaryngol Head Neck Surg. 2025 Mar;77(3):1505-1512. doi: 10.1007/s12070-025-05368-w. Epub 2025 Feb 6. PMID: 40093436; PMCID: PMC11909309.
14 Honkanen J, Molnár K, Karhumaa T, Kakko S, Koivunen P, Franssila H, Koskela U, Erkinaro T, Liisanantti J. Patients undergoing thyroid surgery suffer preoperatively from poor quality of life. J Endocrinol Invest. 2025 Jul 29. doi: 10.1007/s40618-025-02661-x. Epub ahead of print. PMID: 40728709.
15 StataCorp. 2023. Stata Statistical Software: Release 18. College Station, TX: StataCorp LLC
16 Monzani ML, Piccinini F, Boselli G, Corleto R, Margiotta G, Peeters RP, Simoni M, Brigante G. Changes in quality of life after thyroidectomy in subjects with thyroid cancer in relation to the dose of levothyroxine. J Endocrinol Invest. 2023 Feb;46(2):319-326. doi: 10.1007/s40618-022-01903-6. Epub 2022 Aug 21. PMID: 35988109.
17 Yu HW, An AR, Kang HI, Suh YJ, Kwon H, Kim SJ, Chai YJ, Choi JY, Choi H, Lee KE, Cho B. Does Thyroidectomy Impact Quality of Life: Retrospective Case-Control Study of Post-Thyroidectomy Patients and Matched Individuals from the General Population. Medicina (Kaunas). 2020 Nov 10;56(11):603. doi: 10.3390/medicina56110603. PMID: 33182641; PMCID: PMC7697461.
18 Bergenfelz A, Jansson S, Kristoffersson A, Mårtensson H, Reihnér E, Wallin G, Lausen I. Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg. 2008 Sep;393(5):667-73. doi: 10.1007/s00423-008-0366-7. Epub 2008 Jul 17. PMID: 18633639.
19 Ritchie M, Yeap BB. Thyroid hormone: Influences on mood and cognition in adults. Maturitas. 2015 Jun;81(2):266-75. doi: 10.1016/j.maturitas.2015.03.016. Epub 2015 Mar 28. PMID: 25896972.
20 Caglià P, Puglisi S, Buffone A, Bianco SL, Okatyeva V, Veroux M, Cannizzaro MA. Post-thyroidectomy hypoparathyroidism, what should we keep in mind? Ann Ital Chir. 2017;6:371-381. PMID: 29197191.
21 Dedivitis RA, Aires FT, Cernea CR. Hypoparathyroidism after thyroidectomy: prevention, assessment and management. Curr Opin Otolaryngol Head Neck Surg. 2017 Apr;25(2):142-146. doi: 10.1097/MOO.0000000000000346. PMID: 28267706.
22 Kim GJ, Bang J, Shin HI, Kim SY, Bae JS, Kim K, Kim JS, Hwang YS, Shim MR, Sun DI. Persistent subjective voice symptoms for two years after thyroidectomy. Am J Otolaryngol. 2023 May-Jun;44(3):103820. doi: 10.1016/j.amjoto.2023.103820. Epub 2023 Mar 1. PMID: 36893530.
23 Kurumety SK, Helenowski IB, Goswami S, Peipert BJ, Yount SE, Sturgeon C. Post-thyroidectomy neck appearance and impact on quality of life in thyroid cancer survivors. Surgery. 2019 Jun;165(6):1217-1221. doi: 10.1016/j.surg.2019.03.006. Epub 2019 Apr 26. PMID: 31030973.
24 Linos D, Economopoulos KP, Kiriakopoulos A, Linos E, Petralias A. Scar perceptions after thyroid and parathyroid surgery: comparison of minimal and conventional approaches. Surgery. 2013 Mar;153(3):400-7. doi: 10.1016/j.surg.2012.08.008. Epub 2012 Sep 12. PMID: 22980435.
25 Dordea M, Aspinall SR. Short and long-term cosmesis of cervical thyroidectomy scars. Ann R Coll Surg Engl. 2016 Jan;98(1):11-7. doi: 10.1308/rcsann.2016.0022. PMID: 26688393; PMCID: PMC5234393.
26 Felix C, Russell JO, Juman S, Medford S. Cervical scar satisfaction post conventional thyroidectomy. Gland Surg. 2019 Dec;8(6):723-728. doi: 10.21037/gs.2019.11.17. PMID: 32042680; PMCID: PMC6989920.
27 Hedman C, Djärv T, Strang P, Lundgren CI. Effect of Thyroid-Related Symptoms on Long-Term Quality of Life in Patients with Differentiated Thyroid Carcinoma: A Population-Based Study in Sweden. Thyroid. 2017 Aug;27(8):1034-1042. doi: 10.1089/thy.2016.0604. Epub 2017 Jun 5. PMID: 28474541.
28 Rogers SN, Mepani V, Jackson S, Lowe D. Health-related quality of life, fear of recurrence, and emotional distress in patients treated for thyroid cancer. Br J Oral Maxillofac Surg. 2017 Sep;55(7):666-673. doi: 10.1016/j.bjoms.2016.09.001. Epub 2017 Jun 23. PMID: 28648407.
29 Bãrbus E, Pestean C, Larg MI, Piciu D. Quality of life in thyroid cancer patients: a literature review. Clujul Med. 2017;90(2):147-153. doi: 10.15386/cjmed-703. Epub 2017 Apr 25. PMID: 28559697; PMCID: PMC5433565.
30 Mishra A, Sabaretnam M, Chand G, Agarwal G, Agarwal A, Verma AK, Mishra SK. Quality of life (QoL) in patients with benign thyroid goiters (pre- and post-thyroidectomy): a prospective study. World J Surg. 2013 Oct;37(10):2322-9. doi: 10.1007/s00268-013-2133-3. PMID: 23838927.
Submitted date:
12/05/2024
Accepted date:
09/16/2025
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