| Objective:Comparing the(endoscopic thyroidectomy via the areola, ETCAA) and(open thyroidectomy, OT) two groups of patients after 6 months of patient satisfaction with cosmetic scars, self-awareness score and observers Vancouver scar score explore ETCAA forward cosmetic results; subgroup analysis different sexes、ages and different time after long-term cosmetic results in patients; correlation analysis of two groups of patients Vancouver scar score and Beauty satisfaction scores and scores of self-consciousness scars, scars and subjective patient satisfaction degree of correlation. Methods:From the October 2012 Month- January 2016 patients(First Affiliated Hospital of Jinan University) thyroid surgery in patients with a total of 219 cases of Guangzhou Overseas Chinese Hospital, inclusion criteria:(1) bilateral resection of benign thyroid nodules or differentiated thyroid cancer(subtotal / subtotal / total resection);(2) with or without central lymph node dissection. Exclusion criteria:(1) substernal goiter;(2) severe hyperthyroidism; the outer(3) carotid dissection persons;(4) postoperative bleeding, breathing difficulties and even suffocation OT need to dismantle the original incision suture neck ETCAA or otherwise treated by neck incision;(5) previous history of neck surgery or radiation;(6) coagulation abnormalities;(7) long-term use of anti-platelet drugs, which ETCAA group of 141 cases, OT group, 78 cases were bilateral thyroid lesions, bilateral resection(subtotal / subtotal / total resection). Two groups of patients were outpatient follow-up, did not take the initiative to return to the hospital referral by phone and inform their understanding of the situation after return to hospital were followed up for at least 6 months after surgery. Collected by questionnaire patient satisfaction score of beauty, self-awareness scar score by two observers Vancouver scar rates averaged according to Vancouver Scar Assessment Scale, analyzed the long-term cosmetic results of the two groups of patients. Then two groups of patients with long-term cosmetic results sexes, different ages, different postoperative time subgroups were statistically analyzed. Two groups of patients with Vancouver scar score and Beauty satisfaction scores and scars of self-consciousness score correlation analysis to understand the characters and scar patients’ subjective satisfaction degree of correlation. Using SPSS 17.0 statistical software package for statistical analysis, measurement data to x ± s that count data in%, P value of <0.05 was considered statistically significant. Two groups of patients for general information and tumor size using the Student’s t test and χ2 test; beauty satisfaction ratings, scars of self-consciousness score, Vancouver scar scores were compared using Mann-Whitney U rank sum test; Vancouver scar score and Beauty satisfaction score, Vancouver scar scar score and score in self-awareness using Spearman’s correlation analysis. Results:1、141 patients selected row ETCAA procedure, were successfully completed without conversion to open cases. The overall long-term cosmetic results ETCAA group than OT group(P <0.001 both), in which the beauty Satisfaction Rating ETCAA group is 3.14 ± 2.49, OT group was 4.91 ± 3.71(P <0.001), the degree of consciousness scars Rating ETCAA group was 1.62 ± 2.78, OT group was 3.29 ± 5.28(P <0.001), Vancouver Rating scale average score ETCAA group was 1.03 ± 0.68, OT group was 2.05 ± 0.84(P <0.001). In the present study, scoring system, low corresponding to more satisfactory cosmetic effect, completely areola endoscopic thyroid surgery for the treatment of patients are more satisfied with their breast surgery at no scarring or scar concealment.2、ETCAA group Q1 in the beauty satisfaction questionnaire mean or Q2(scar) and Q3(the contour of the neck) were(1.41 ± 0.64, 1.73 ± 0.89), than open group(2.50 ± 0.95, 2.41 ± 0.92)(P <0.001 both). Beauty ETCAA group satisfaction on Q1 / Q2(scar) and Q3(the contour of the neck) of long-term postoperative cosmetic results better than OT group. Scar meaning questionnaire, ETCAA and OT group on Q4(scarring caused by the level of attention of others) the average score(P <0.001), Q5(try to hide scars) the average score(P <0.001), Q6(how much you often think of your scar) average score(P = 0.006), Q7(scars affect you in your clothing choices) the average value(P = 0.006), were statistically significant.3、Vancouver scar score and Beauty satisfaction scores and scores of self-consciousness scar there is a certain correlation, suggesting scars traits and subjective patient satisfaction have some relevance. Vancouver Scar Scale score on the neck below the breast score(P <.001 both). ETCAA group Vancouver scar scale score and Beauty satisfaction scores(correlation coefficient Spearman’s R = 0.224, P = 0.670) there is no correlation with the scar awareness score(Spearman correlation coefficient R = 0.883, P = 0.005) significantly Correlation. There was a significant correlation OT group Vancouver Scar Scale Rating Beauty and neck forward satisfaction satisfaction scores(Spearman’s R = 0.860, P = 0.013) and scar awareness score(Spearman’s R = 0.857, P = 0.002) between sex.4、Subgroup analysis, the two groups of male patients, elderly patients cosmetic satisfaction and self-awareness scar score was no significant difference, ETCAA group and OT group of male beauty satisfaction survey score average of(3.12 ± 1.05,4.32 ± 1.57), P = 0.067, scar awareness survey average of(0.79 ± 1.14,3.15 ± 1.84), P = 0.060. Age greater than or equal to the beauty satisfaction surveys 45 year old patient ET CAA and OT group score average of(4.02 ± 1.52,5.02 ± 1.96),(P = 0.058), in the sense of questionnaire scars mean average of(1.67 ± 2.43,3.46 ± 3.70)(P = 0.054).5、Subgroup analysis, a long time after the two groups of patients satisfaction and beauty scars of self-consciousness score was no significant difference, suggesting that over time, patients have to accept the presence of scars, not too concerned about. Over time, satisfaction has increased, but ETCAA group, or slightly better. Follow-up time(<18 months) and the average value of ETCAA OT group was(12.7 ± 1.34,13.2 ± 1.46), P = 0.007, statistically significant, consider the difference between the two, and the follow-up time> 18 months time, ETCAA the mean OT group was(22.9 ± 3.15,23.1 ± 3.42), P = 0.0542, not significant differences.Conclusion:1、through the use of data objectively reflect Full Full areola approach endoscopic thyroidectomy long-term cosmetic results better than traditional open surgery. Since the group ETCAA cut 0.5-1.0cm small incision in the areola, although patients know they have surgical incision, but healed well, and hidden, clothes can hide it.2、scars and subjective patient satisfaction have some relevance.3、male patients, elderly patients satisfaction and beauty scars of self-consciousness score was no significant difference, suggesting that male patients and elderly patients is not particularly strong demand for beauty guide some patients surgical options.4、over time, patient satisfaction and cosmetic scars of self-consciousness score was no significant difference in patients already accept the existence of scars, not too concerned about. Over time, satisfaction has increased, but the ETCAA group, or slightly better. |
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