Erhan Aysan1, Ufuk Oguz Idiz2,3, Huseyin Akbulut1, Leyla Elmas1. 1. Department of General Surgery, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul, Turkey. 2. Department of General Surgery, Bezmialem Vakif University, Faculty of Medicine, Fatih, Istanbul, Turkey. oguzidiz@hotmail.com. 3. Sisli Etfal Training and Research Hospital, Department of General Surgery, Istanbul, Turkey. oguzidiz@hotmail.com.
Abstract
PURPOSE: The activity of the application of single-session ultrasonography (US)-guided percutaneous radio frequency ablation (RFA) in benign thyroid nodules was investigated in this prospective clinical study. METHODS: RFA treatment was applied to 100 nodules in 100 patients (78 women, 22 men; average age 44.5 years old; age range 18-71) who had euthyroid condition, nodule size larger than 1 cm in the ultrasonography, proven to be benign by fine needle aspiration cytology. The nodules were separated into three groups according to the content: solid, cystic and mixed. In first 73 cases, the process performed under local anesthesia and the other 27 cases were performed under general anesthesia. RFA process was standardized to 70 W in all of the patients, and a moving shot technique was used. The results acquired in the third and sixth months of the controls were evaluated, and the volume of the nodules was screened. RESULTS: No differences between the thyroid function tests performed before and after RFA were detected (p > 0.05). The mean volume of the nodules before the process, in the third month after the process, and in the sixth month were 16.8, 4.8, and 2.6 ml, respectively (p < 0.001). The decrease in cystic nodules was greater than solid and mixed structures. Temporary hoarseness occurred in one case and skin edema was detected in a patient at the isthmus. CONCLUSIONS: RFA is an option for treatment, with minimal invasiveness and a low complication rate, and it is effective primarily in cases with benign nodules and nodular goiter. In cases with good compliance, the likelihood of success is greater. General anesthesia can be a good option for anxious cases to gather better results.
PURPOSE: The activity of the application of single-session ultrasonography (US)-guided percutaneous radio frequency ablation (RFA) in benign thyroid nodules was investigated in this prospective clinical study. METHODS: RFA treatment was applied to 100 nodules in 100 patients (78 women, 22 men; average age 44.5 years old; age range 18-71) who had euthyroid condition, nodule size larger than 1 cm in the ultrasonography, proven to be benign by fine needle aspiration cytology. The nodules were separated into three groups according to the content: solid, cystic and mixed. In first 73 cases, the process performed under local anesthesia and the other 27 cases were performed under general anesthesia. RFA process was standardized to 70 W in all of the patients, and a moving shot technique was used. The results acquired in the third and sixth months of the controls were evaluated, and the volume of the nodules was screened. RESULTS: No differences between the thyroid function tests performed before and after RFA were detected (p > 0.05). The mean volume of the nodules before the process, in the third month after the process, and in the sixth month were 16.8, 4.8, and 2.6 ml, respectively (p < 0.001). The decrease in cystic nodules was greater than solid and mixed structures. Temporary hoarseness occurred in one case and skin edema was detected in a patient at the isthmus. CONCLUSIONS: RFA is an option for treatment, with minimal invasiveness and a low complication rate, and it is effective primarily in cases with benign nodules and nodular goiter. In cases with good compliance, the likelihood of success is greater. General anesthesia can be a good option for anxious cases to gather better results.
Authors: Pierpaolo Trimboli; Marco Castellana; Luca Maria Sconfienza; Camilla Virili; Lorenzo Carlo Pescatori; Roberto Cesareo; Francesco Giorgino; Roberto Negro; Luca Giovanella; Giovanni Mauri Journal: Endocrine Date: 2019-07-20 Impact factor: 3.633