BENİGN MULTİNODÜLER GUATR NEDENİ İLE TOTAL VE SUBTOTAL TİROİDEKTOMİ YAPILAN HASTALARDA UZUN DÖNEM HAYAT KALİTESİ SONUÇLARI AÇISINDAN KARŞILAŞTIRILMASI

Öz

Literatürde total tiroidektomi ile subtotal tiroidektomi ameliyatlarından hangisinin tercih edileceği konusu; genellikle ameliyatın komplikasyonları, hastalık nüksü ve insidental malignitelerin tedavisi yönünde olmaktadır. Ancak bu iki ameliyat yöntemini hayat kalitesine etkileri açısından karşılaştıran bir çalışma literatürde mevcut değildir. Bu çalışmada amaç; kliniğimizde benign Multinoduler Guatr nedeni ile total ve subtotal tiriodektomi yapılan hastaların uzun dönem hayat kalitesi sonuçlarını karşılaştırmaktır. Bu çalışmada, benign multinoduler guatr nedeniyle total ve subtotal tiroidektomi yapılan 191 hasta, kesitsel olarak olarak incelendi.. Kalıcı sinir hasarı gelişen, insedental malignite tespit edilen, tirotoksikoz nedeniyle opere edilen ve yaşam kalitesini etkileyecek yandaş hastalıkları olan hastalar çalışma dışı tutuldu. Çalışmaya katılmayı kabul eden ve kriterlere uyan 57 hasta çalışmaya dahil edildi. 57 hastanın 30’una total tiroidektomi (%52,6), 27’sine subtotal tiroidektomi (%47,4) yapıldı, 51’i kadın (%89,5), 6’sı erkek (%10,5), yaş ortalamaları 49,5±12.8 idi. Hastaların ortalama takip süreleri yaklaşık 3,5 yıl idi. Hastaların yaşam kalitesi SF-36 formu ile, anksiyete ve depresyon durumu Hastane Anksiyete ve Depresyon ölçeği kullanılarak değerlendirildi. Her iki grup hastanın karşılaştırılmasında yaşam kalitesi ölçeği ve hastane depresyon ölçeği arasında istatistiksel olarak anlamlı fark gözlendi (p<0,05). Hastane anksiyete ölçeği açısından ise fark saptanmadı. Total tiroidektomi sonrası hastalarda hayat kalitesindeki anlamlı düşüş ve anksiyete depresyon ölçümündeki anlamlı yükseliş bu ameliyat seçeneklerinin bu açılardan tekrar tartışılma gereğini ortaya koymaktadır.

Anahtar Kelimeler

• Multinoduler Guatr
• Hayat Kalitesi
• Tiroidektomi

A comparison of patients who made total and subtotal thyroidectomy due to benign multinodular goitre in terms of long-term quality of life results

Öz

In the literature, the subject of which of total thyroidectomy or subtotal thyroidectomy should be preferred; It is usually in the direction of complications of surgery, disease recurrence and treatment of incidental malignancies. However, there is no study in the literature comparing these two surgical methods in terms of their effects on quality of life. The aim of this study; To compare the long-term quality of life outcomes of patients who underwent total and subtotal thyroidectomy for benign multinodular goiter in our clinic. In this study, 191 patients who underwent total and subtotal thyroidectomy for benign multinodular goiter were analyzed cross-sectionally. Patients who developed permanent nerve damage, had an incidental malignancy, were operated for thyrotoxicosis, and had co-morbidities that would affect their quality of life were excluded from the study. 57 patients who agreed to participate in the study and met the criteria were included in the study. Total thyroidectomy was performed in 30 of 57 patients (52.6%), subtotal thyroidectomy was performed in 27 (47.4%), 51 women (89.5%), 6 men (10.5%), age their mean was 49.5±12.8. The mean follow-up period of the patients was approximately 3.5 years. The patients' quality of life was evaluated with the SF-36 form, and their anxiety and depression status was evaluated using the Hospital Anxiety and Depression Scale. In the comparison of both groups of patients, a statistically significant difference was observed between the quality of life scale and the hospital depression scale (p<0.05). There was no difference in terms of hospital anxiety scale. The significant decrease in the quality of life in patients after total thyroidectomy and the significant increase in the anxiety-depression measurement reveals the necessity of re-discussing these surgical options from these perspectives.

Anahtar Kelimeler

• Multinodular Goiter
• Quality of Life
• Thyroidectomy

Kaynakça

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