a Department of Endocrinology, Diabetology and Metabolism , CHU Lille , Lille , France.
b American Hospital of Paris, Thyroid Unit , Neuilly-sur-Seine , France.
Int J Hyperthermia. 2019;36(1):666-676. doi: 10.1080/02656736.2019.1627432.
Thermal ablation is a minimally invasive technique that is gradually acknowledged as an effective alternative to surgery to treat thyroid nodules. Two main techniques have been described: radiofrequency (RFA) and laser ablation. To evaluate the safety and efficacy of the two main techniques (RFA and laser ablation) for the treatment of benign thyroid nodules. This bicentric retrospective study included 166 consecutive patients, who received clinical, biological and ultrasound evaluations for thyroid nodules, from October 2013 to November 2017. One of the two techniques was proposed if a nodule was proven to be benign after fine needle aspiration cytology or micro-biopsy. Adverse events and outcomes (symptoms, nodule reduction) were assessed at 6 weeks and 6, 12, and 18 months after treatment. One hundred and eighty-nine nodules (mean size 17.5 ± 16.9 mL, 86.1% palpable) were treated by RFA (n = 108 (57.1%)) or laser ablation ( = 81 (42.9%)) in 166 patients (80.1% women, mean age 51.7 years). Two cases of transient recurrent laryngeal nerve palsy, one hematoma, and two successfully drained abscesses (5/166 = 3%) were observed. Clinical symptoms improved significantly in the two groups (anterior cervical discomfort -83.6%, esthetic complaints -84.9% and dysphagia -86.4%). Nodule volume (mL) decreased significantly (baseline 18 months) from 20.4 ± 18.6 to 5.8 ± 6.6 (-75%) in the RFA, and from 13.6 ± 13.3 to 3.4 ± 4.1 (-83.9%) in the laser ablation groups. Transient but potentially serious adverse events were reported in 3% of patients. A significant volumetric reduction was achieved with both techniques, regardless of nodule's characteristics, at 18 months.
热消融是一种微创技术，已逐渐被公认为治疗甲状腺结节的有效手术替代方法。有两种主要技术已被描述：射频（RFA）和激光消融。
为了评估两种主要技术（RFA 和激光消融）治疗良性甲状腺结节的安全性和有效性。这项双中心回顾性研究纳入了 2013 年 10 月至 2017 年 11 月期间接受甲状腺结节临床、生物学和超声评估的 166 例连续患者。如果细针穿刺细胞学或微活检证实结节为良性，则提出其中一种技术进行治疗。在治疗后 6 周和 6、12 和 18 个月评估不良事件和结局（症状、结节缩小）。在 166 例患者中（80.1%为女性，平均年龄 51.7 岁），189 个结节（平均大小 17.5±16.9ml，86.1%可触及）接受了 RFA（n=108[57.1%]）或激光消融（n=81[42.9%]）治疗。观察到 2 例暂时性喉返神经麻痹、1 例血肿和 2 例成功引流脓肿（5/166=3%）。两组临床症状均明显改善（颈前不适-83.6%，美容投诉-84.9%和吞咽困难-86.4%）。结节体积（ml）明显减少（基线 18 个月），RFA 组从 20.4±18.6 降至 5.8±6.6（-75%），激光消融组从 13.6±13.3 降至 3.4±4.1（-83.9%）。报告了 3%的患者发生短暂但潜在严重的不良事件。无论结节特征如何，两种技术在 18 个月时均可实现显著的体积减少。
