Background. An incision less than 3 cm in length in the neck is the main
feature that discriminates the minimally invasive thyroidectomy and
parathyroidectomy from traditional procedures. Smaller neck scars are
assumed to yield better patient satisfaction, although no established
data support this. In this analysis, we evaluated the satisfaction of
patients who had undergone both procedures, while examining the effects
of sociodemographic and surgical characteristics.
Methods. We analyzed data from 691 patients who underwent a
thyroidectomy or parathyroidectomy between January 2000 and March 2010.
We assessed the satisfaction of patients who underwent conventional
compared to minimally invasive procedures, using the validated Patient
Scar Assessment Questionnaire (PSAQ). We included both the appearance
and the consciousness subscales.
Results. Overall, patients were satisfied with their neck scars, as
indicated by the low scores in appearance (13.3; range, 9 to 31) and
consciousness (8.5; range, 6 to 24) subscales. The degree of
satisfaction, improved with increased time since surgery (P<.001).
Patient satisfaction was similar regardless of the procedure used,
implying that smaller scars do not provide better patient satisfaction.
Most patients (81.2%) reported that they would not have preferred a
transaxillary procedure over the procedure they received.
Conclusion. A smaller incision in the neck was not associated with
better patient satisfaction. New surgical approaches aimed at maximizing
cosmesis while minimizing scar size should be evaluated for
cost-effectiveness and clinical outcomes, as well as
patient-satisfaction, before becoming the standard of care. (Surgery
2013;153:400-7.