Quality of life and surgical outcomes of endoscopic thyroidectomy versus open thyroidectomy in papillary thyroid carcinoma

Endoscopic thyroidectomy (ET) avoids larger neck incisions. It offers superior cosmetic outcomes and improves patient satisfaction. However, the effect of ET on quality of life (QoL) remains incompletely investigated. This study was therefore designed to compare QoL and key surgical outcomes between ET and conventional open thyroidectomy (OT) in patients diagnosed with papillary thyroid carcinoma. This retrospective analysis enrolled 667 patients with papillary thyroid carcinoma who underwent thyroidectomy. To mitigate potential confounding factors, propensity score matching was applied, resulting in a final cohort of 44 ET patients and 66 OT patients for comparative analysis. The SF-36 and thyroid surgery-specific questionnaires were used to assess QoL, overall satisfaction, surgical and cosmetic outcomes at 15, 30, and 60 days postoperatively. Patients in the ET group generally exhibited higher SF-36 QoL scores than those in the OT group across several parameters. Thyroid surgery-specific questionnaires indicated lower swallowing discomfort in the ET group (P < .05). Significant differences were observed in operating time (P < .001), cosmetic outcomes (P < .001), hospital costs (P < .001), and overall satisfaction (P < .001). The ET group included a higher proportion of higher educated individuals (P < .05). No significant intergroup differences were observed in terms of postoperative drainage, visual analogue scale pain scores, length of hospital stay, or complication rates. ET offers comparable safety to OT, along with superior QoL and cosmetic outcomes, making it a viable alternative for both patients and surgeons.