title: A survey of preferences regarding surgical approach to thyroid surgery.
abstract: BACKGROUND
  Transaxillary thyroidectomy (TAT) has gained popularity in East Asian countries; however, to date there have been no attempts to evaluate the preferences regarding TAT in the US population. The aim of this study is to assess the preferences and considerations associated with TAT in an American cohort.
  
  
  METHODS
  Self-administered surveys were distributed to 966 adults at various locations in a single state. Questions assessed preferences for the surgical approach, acceptable risks and extra costs, and willingness to pursue TAT despite reduced cancer treatment efficacy.
  
  
  RESULTS
  The response rate was 84 %, with a mean age of 40 ± 17 years. The majority of respondents were female. Of the respondents, 82 % preferred TAT to a cervical thyroidectomy (CerT), all risks being equal; 51 % of the respondents were willing to accept a 4 % complication rate with TAT, and 16 % stated they would agree to pay up to an additional $US5,000 for the TAT approach. When presented with thyroid cancer, 20 % of all respondents still preferred TAT, even if it would not cure their disease. Patients preferring TAT over CerT were younger, female, more willing to accept complications and spend additional money, and, most significantly, preferred the TAT approach, even if it was less likely to cure their cancer.
  
  
  CONCLUSIONS
  Although this survey presents a hypothetical question for people who do not have thyroid disease, the majority of respondents preferred TAT over CerT. Furthermore, a substantial number were willing to accept higher complication rates and increased costs for TAT.
authors.affiliation: Department of Surgery, University of Wisconsin, Madison, WI, USA.
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Coorough
authors.forename: David F
authors.initials: DF
authors.lastname: Schneider
authors.forename: Monica Woll
authors.initials: MW
authors.lastname: Rosen
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Sippel
authors.forename: Herbert
authors.initials: H
authors.lastname: Chen
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Schwarze
authors.forename: Haggi
authors.initials: H
authors.lastname: Mazeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data*; D013964:Thyroid Neoplasms / Q000191:economics / Q000601:surgery*; D013965:Thyroidectomy / Q000191:economics / Q000379:methods*; D014481:United States; D055815:Young Adult