Effect of complicated thyroid surgical procedures on personal and professional life of patients.

UNLABELLED: Thyroid resection procedures are the most common endocrine surgery procedures in Poland; an estimated 25,000 procedures are performed annually. Long term patient outcomes are rarely analyzed.

THE AIM OF THE STUDY: was to assess effect of complicated thyroid burgery procedures on personal and Professional life of patients.

MATERIAL AND

METHODS

Follow-up of patients with complications was conducted according to a predetermined protocol involving survey and biochemistry.

RESULTS

Unilateral and bilateral vocal cord paralysis accounted for 69% and 8% of complications, respectively. The complications resolved unilaterally in 58% of patients with bilateral vocal cord paralysis. Persistent hypoparathyroidism accounted for 26% of cases of postoperative hypoparathyroidism. Following thyroid resection procedures all patients received supplementation of thyroid hormones and were monitored by an endocrinologist until their follow-up examination. Eighty eight percent patients with vocal cord paralysis were treated at an outpatient department of laryngology and/or speech therapy. Physical therapy resulted in improvement irrespective of final nature of the complications. Vocal cord paralysis or both complications concurrently result in marked prolongation of absence from work and resulted in disability pension in 15% of professionally active patients. Low level of adaptation to disease was found in 19% patients in the study group, while low score on Satisfaction with Life Scale (SWLS) was found in 17% patients in the study group, irrespective of the type of complication.

CONCLUSIONS

Acceptance of complications after thyroid surgical procedures is difficult for patients and worsens their life satisfaction in the long term follow-up and adversely modifies their professional and personal life. In the long term perspective, persistent hypoparathyroidism is more burdensome for patients than recurrent laryngeal nerve injury. Chronic deficit of innervations does not require chronic substitution or specialist therapy that are necessary in the persistent hypoparathyroidism.