The Second Department of General Surgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong Province, China.
Affiliated Foshan Hospital of Southern Medical University, Foshan, Guangdong Province, China.
Eur J Endocrinol. 2021 Jan;184(1):131-141. doi: 10.1530/EJE-20-0562.
The complications and treatment effects of conventional thyroidectomy and thyroid thermal ablation should be compared in order to identify the best intervention for patients with benign thyroid nodules.
Patients (18-50 years old) who had benign thyroid nodules and were eligible for both thyroidectomy and thyroid thermal ablation were randomly allocated (1:1) to either conventional thyroidectomy group or thyroid thermal ablation group. Patients' satisfaction and condition-specific quality of life were measured with the Thyroid-Specific Quality-of-Life Questionnaire Scale (QoL) at the 15th post-randomization month and were set as the co-primary outcome.
A total of 450 patients were enrolled and randomized (225 patients in each group). At the 15th month after randomization, more patients in the thyroid thermal ablation group were satisfied with the treatment effects compared to those in the conventional thyroidectomy group. More patients in the thyroid thermal ablation group have a QoL score of 410 (QOL scores ranges from 0 to 410) than patients in conventional thyroidectomy. Eight (4%) of the 209 patients in conventional thyroidectomy group and 6 (3%) of the 208 patients in thyroid thermal ablation group had at least one severe postoperative complication. The time to achieve volume reduction was longer in the thermal ablation group.
Thyroid thermal ablation is superior to conventional thyroidectomy in terms of patients satisfaction, post-operative quality of life, and shorter hospital stay but takes longer to achieve BTNs volume reduction. The complication rates between the two groups were similar.
比较传统甲状腺切除术和甲状腺热消融术的并发症和治疗效果,以确定治疗良性甲状腺结节患者的最佳干预措施。
将年龄在 18-50 岁、适合行甲状腺切除术和甲状腺热消融术的良性甲状腺结节患者,按 1:1 比例随机分为传统甲状腺切除术组或甲状腺热消融术组。采用甲状腺特异性生存质量问卷(QoL)量表于随机分组后第 15 个月测量患者的满意度和与疾病相关的生活质量,并将其作为主要共同结局。
共纳入 450 例患者并进行随机分组(每组 225 例)。在随机分组后第 15 个月,甲状腺热消融术组的患者对治疗效果的满意度高于传统甲状腺切除术组。甲状腺热消融术组有 410 分(QOL 评分范围为 0-410)的患者比例高于传统甲状腺切除术组。传统甲状腺切除术组的 209 例患者中有 8 例(4%)和甲状腺热消融术组的 208 例患者中有 6 例(3%)至少发生 1 种严重术后并发症。热消融组达到体积缩小的时间更长。
与传统甲状腺切除术相比,甲状腺热消融术在患者满意度、术后生活质量和住院时间方面更具优势,但达到 BTNs 体积缩小的时间更长。两组的并发症发生率相似。