Abstract

Background: Postoperative quality of life (QoL) following surgery ‎for Graves' disease is not well documented and the effect of different surgical operations has not been compared. This study examines the impact of a shift in policy from operations intended to preserve thyroid function (PF) to those ablating function (AF) on QoL. Methods: A cross-sectional assessment was performed on patients who underwent surgery for Graves' disease between 1986 and 2008 in a tertiary endocrine surgical unit. Patients completed the Short ‎Form 36 (SF-36) questionnaire by post. SF-36 scores, including the ‎physical (PCS) and mental component summaries (MCS), were compared with the general population and by operative intent (AF versus PF). Statistical ‎analyses were performed using SPSS 16.0 (Chicago, IL). Results: Of 150 patients, three had died of unrelated causes and 14 were not contactable. In the remaining 133 cases, the median age at time of assessment was 46 years (Interquartile range 42 - 50) and 43 years (Interquartile range 33 - 47) in the PF and AF groups respectively. From these patients, 87 questionnaires (65.4% response rate) were completed with an item completion rate of 99.3%. The median follow-up was 18.4 years for PF and 7.9 years for AF surgery. Of 87 ‎respondents, 38 (43.7%) underwent PF ‎and 49 (56.3%) AF surgery. Study participants reported lower scores across all SF-36 subscales than British norms (P < 0.05). ‎Comparisons on operative intent showed no significant difference ‎in long-term QoL (P > 0.05). Conclusion: The shift to ablative surgery simplifies postoperative ‎management with no adverse effect on QoL, justifying this practice from a patient perspective. ‎