Swarna Azaria, (2019) Quality of life Post Thyroidectomy in Benign Goitres. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION: A goitre is defined as a visibly enlarged thyroid gland. With progressive growth, direct pressure effects like hoarseness of voice, dysphagia and dyspnea can occur. Hormonal dysfunction affecting the thyroid gland also needs therapeutic intervention. Patients with benign goitres without these symptoms may undergo surgical intervention because of cosmetic disfigurement. However, this is often deferred due to disfigurement of the intervention or a fear of the complications of the intervention. Goitres also can be as a result of malignancy, which needs surgical intervention in most patients. Such effects are sometimes distressing and often the precipitating factor in seeking treatment. However, benign thyroid diseases encompass a large spectrum of conditions that are chronic and subtle in nature without obvious pressure symptoms, hormonal dysfunction or features of malignancy. There are symptoms that cause subconscious disruption of good quality of life but are never dramatic enough to be able to pin them down to the thyroid disease. Another matter of great interest is that patients who are devoid of thyroid dysfunction and report to the outpatient department with no other complaints except for the goitres also have reported a general impaired quality of life on health related quality of life assessment. OBJECTIVES: 1. To assess the impact of thyroidectomy on QOL in patients with benign goitres using the ThyPRO 39 questionnaire. 2. To assess the significance of age, gender, type of goitre, specimen weight and dimension, duration of symptoms, functional status, post operative hypocalcaemia and pathology on quality of life following thyroidectomy. METHODS: 50 patients between January 2017 and August 2018 were prospectively evaluated using the ThyPRO 39 questionnaire, developed by Torquil Watt. This was administered pre operatively and six months following the operation to assess impact in quality of life post thyroidectomy. The variables affecting the outcome and having a bearing on the overall quality of life were also studied. RESULTS: The mean age of the study population was 43.30 years ± 11.61. A female preponderance was noted (34:16). The mean duration of symptoms was 49.46 ± 40.40 months and the majority of the patients were euthyroid (74%). The mean duration of hormonal dysfunction in hyperthyroid patients was 39.92 ± 28.35 months. The most common presentation was multinodular goitre in 23 (46%) and the most common indication for surgery was progressive increase in size of the goitre (62%). 90% of the patients underwent total thyroidectomy with the mean weight of the thyroidectomy specimen being 73.62 gm. The most common histopathology report was nodular/ adenomatous hyperplasia (62%). Univariate analysis showed a significant association between age (p=0.011), gender (p=0.015) and duration of symptom (p=0.049) with post thyroidectomy improvement in quality of life. However, none of these factors were significant on multivariate analysis. All the 12 domains listed in the ThyPRO 39 questionnaire were compared post operatively, and there was a significant change in all domains except for depression (p=0.126). Further, comparison of pre and post operative composite score revealed a significant improvement in the quality of life postoperatively (0.00). CONCLUSION: There was a significant improvement in quality of life post thyroidectomy in all domains except depression. The study also detected baseline impairment in quality of life pre operatively. Thus offering surgery benefits the patient with overall improvement in quality of life.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Quality of life, Post Thyroidectomy, Benign Goitres. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 02 Sep 2019 06:00 |
| Last Modified: | 02 Sep 2019 06:00 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11389 |
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