Patientenzufriedenheit nach Thyreoidektomie – die Breite der Narbe ist wichtiger als die Länge

Zusammenfassung

Hintergrund Zur Vermeidung einer Narbe am Hals wurden alternative Verfahren zur Thyreoidektomie entwickelt. Ziel unserer Studie war es, die Bedeutung der Narbe und die Einflussfaktoren für die Zufriedenheit nach klassischer Thyreoidektomie im Langzeitverlauf festzustellen.

Material und Methoden 228 Patienten, die sich zwischen 2001 und 2014 wegen einer gutartigen Schilddrüsenerkrankung einer partiellen oder totalen Thyreoidektomie unterzogen hatten, nahmen an einer telefonischen Befragung teil. Neben der Zufriedenheit der Patienten wurden demographischen Daten, das subjektive Erscheinungsbild der Narbe und subjektive Beschwerden erfasst.

Ergebnisse 93,8 % der Patienten waren mit der Behandlung zufrieden. Weibliche und jüngere Patienten waren tendenziell unzufriedener als männliche und ältere. Die mittlere Narbenlänge betrug 6,03 ± 2,36 cm und die mittlere Narbenbreite 2,01 ± 1,46 mm. Die Länge der Narbe hatte keinen Einfluss auf die Zufriedenheit. Dagegen waren Patienten mit einer breiteren prominent oder auffällig verfärbten Narbe signifikant unzufriedener. Patienten, die postoperativ dauerhaft an Beschwerden wie Druckgefühl oder Schluckbeschwerden litten, waren ebenfalls signifikant unzufriedener. Kosmetische Probleme beeinflussen die Zufriedenheit stärker als funktionelle Probleme.

Schlussfolgerungen Die Zufriedenheit nach Thyreoidektomie ist im Langzeitverlauf gut. Ob durch die Anwendung eines alternativen bzw. minimalinvasiven Verfahrens die Zufriedenheit weiter verbessert werden kann, ist fraglich. Diese Verfahren sind gegebenenfalls eine Alternative für jüngere und weibliche Patienten oder solche, die einen hohen Wert auf Kosmetik legen.

Abstract

Objective To avoid a scar on the neck, alternative methods of thyroidectomy have been developed. The aim of our study was to determine the significance of the scar and the factors influencing satisfaction after classical thyroidectomy in the long term.

Material and Methods 228 patients who underwent partial or total thyroidectomy for benign thyroid disease between 2001 and 2014 participated in a telephone interview. In addition to patient satisfaction, demographic data, the subjective appearance of the scar, and subjective complaints were recorded.

Results 93.8 % of the patients were satisfied with the treatment. Female and younger patients tended to be more dissatisfied than both male and older patients. The mean scar length was 6.03 ± 2.36 cm and the mean scar width was 2.01 ± 1.46 mm. The length of the scar did not affect satisfaction. In contrast, patients with a wider prominent or conspicuously stained scar were significantly more dissatisfied. Patients who suffered from symptoms such as pressure or difficulty swallowing postoperatively were also significantly more dissatisfied. Cosmetic problems affect satisfaction more than functional problems.

Conclusions Satisfaction after thyroidectomy is good in the long term. Whether satisfaction can be further improved by using an alternative or minimally invasive procedure is questionable. These procedures may be an alternative for younger and female patients or those who focuses on cosmetics.

Schlüsselwörter

Thyreoidektomie - minimalinvasive Schilddrüsenresektion - Kocher’scher Kragenschnitt - Narbenlänge - Patientenzufriedenheit

Key words

Thyroidectomy - minimally invasive thyroid resection - Kocher’s incision - scar length - patient satisfaction

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