Døssing Helle, Bennedbæk Finn Noe, Hegedüs Laszlo
Department of Oto-rhino-laryngology and Neck Surgery, Odense University Hospital, Odense, Denmark.
Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
Endocr Connect. 2019 Jul;8(7):846-852. doi: 10.1530/EC-19-0236.
Laser therapy (LT) is considered a safe and effective procedure for inducing thyroid nodule necrosis, fibrosis and shrinkage. Little is known about long-term efficacy of LT in benign complex thyroid nodules, which we report here.
One hundred and ten euthyroid outpatients (28 men and 82 women; median age 48 years (range 17-82)) with a recurrent cytologically benign cystic (≥2 mL cyst volume) thyroid nodule causing local discomfort were assigned to LT. LT was performed after complete cyst aspiration and under continuous ultrasound (US) guidance. Nineteen patients (17 within 6 months) had surgery after LT. The median follow-up for the remaining 91 patients was 45 months (range: 12-134).
The overall median nodule volume in the 110 patients decreased from 9.0 mL (range: 2.0-158.0) to 1.2 mL (range: 0.0-85.0) (P < 0.001) at the final evaluation, corresponding to a median reduction of 85% (range: -49 to 100%). Remission of the cystic part (volume ≤1 mL) was obtained in 82 of 110 (75%) patients after LT. The median cyst volume decreased from 6.3 mL (range: 2.0-158.0) to 0.0 mL (range: 0.0-85.0) (P < 000.1), corresponding to a median reduction of 100% (range: -49 to 100%). These results correlated with a significant decrease in pressure as well as cosmetic complaints. Side effects were restricted to mild local pain.
US-guided aspiration and subsequent LT of benign recurrent cystic thyroid nodules results in a satisfactory long-term clinical response in the majority of patients. LT constitutes a clinically relevant alternative to surgery in such patients.
激光治疗（LT）被认为是一种诱导甲状腺结节坏死、纤维化和缩小的安全有效的方法。关于LT对良性复杂性甲状腺结节的长期疗效知之甚少，我们在此报告。
110例甲状腺功能正常的门诊患者（28例男性和82例女性；中位年龄48岁（范围17 - 82岁）），患有复发性细胞学检查为良性的囊性（囊肿体积≥2 mL）甲状腺结节并引起局部不适，被分配接受LT治疗。LT在完全抽出囊肿液后并在持续超声（US）引导下进行。19例患者（17例在6个月内）在LT后接受了手术。其余91例患者的中位随访时间为45个月（范围：12 - 134个月）。
在最终评估时，110例患者的总体中位结节体积从9.0 mL（范围：2.0 - 158.0 mL）降至1.2 mL（范围：0.0 - 85.0 mL）（P < 0.001），对应中位缩小85%（范围：-49%至100%）。LT后，110例患者中有82例（75%）的囊性部分（体积≤1 mL）缓解。中位囊肿体积从6.3 mL（范围：2.0 - 158.0 mL）降至0.0 mL（范围：0.0 - 85.0 mL）（P < 0.001），对应中位缩小100%（范围：-49%至100%）。这些结果与压力以及美容方面的不适显著减轻相关。副作用仅限于轻度局部疼痛。
超声引导下抽吸并随后对良性复发性囊性甲状腺结节进行LT治疗，在大多数患者中产生了令人满意的长期临床反应。LT在此类患者中构成了一种与手术具有临床相关性的替代方法。
