Nguyen Van Bang, Nguyen Thi Xuan, Nguyen Van Vy Hau, Pham Nguyen Tuyen Linh, Nguyen Hai Thuy, Dinh Toan Nguyen, Le Chi Van
Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam.
Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.
Ther Clin Risk Manag. 2023 Jan 24;19:97-104. doi: 10.2147/TCRM.S393213. eCollection 2023.
This study aims to compare 1-month's efficacy and safety of single-session ethanol ablation and radiofrequency ablation for treating both purely cystic nodules and predominantly cystic thyroid nodules.
This short-term retrospective study was approved by the Ethics Committee of the Institutional Review Board of Danang Family hospital, and written informed consent for procedures was obtained for all patients. Thirty-nine patients who presented with cystic thyroid nodules and met inclusion criteria were extracted from the computerized medical records. The internal fluid of cystic thyroid nodules was aspirated as much as possible. Ethanol ablation was performed using 18-gauge needles with 99.5% ethanol, and RFA used a cooled-electrode RFA system and 18-gauge internally cooled electrodes via the trans-isthmic approach, moving-shot technique. Nodule volume, therapeutic success rate, the largest diameter, thyroid function tests, and complications were evaluated and compared before and after treatment in each group.
Among 39 patients, 17 patients were undergone EA (mean age of 47.35 years; the proportion of female of 76.5%; purely thyroid cyst percentage of 41.4%) and 22 patients were undergone RFA (mean age of 46.63 years; the proportion of female of 86.4%; purely thyroid cyst percentage of 54.5%). Both treatment techniques showed a significant reduction of the largest diameter and nodule volume (p<0.05) without complications. RFA reduced nodule volume and the largest nodule size greater than EA treatment at 1-month post-ablation (p<0.05). In addition, the therapeutic success rate in the RFA group was higher than in the EA group.
Both RFA and EA treatment with single-session confirm the efficacy and safety for cystic thyroid nodules at 1-month follow-up, RFA reduced greater in nodule volume and the largest nodule size than the EA treatment. Thus, the therapeutic success rate in the RFA group was higher than in the EA group.
本研究旨在比较单次乙醇消融和射频消融治疗单纯性囊性结节及以囊性为主的甲状腺结节1个月后的疗效和安全性。
本短期回顾性研究经岘港家庭医院机构审查委员会伦理委员会批准，所有患者均获得手术的书面知情同意书。从计算机化医疗记录中提取39例患有甲状腺囊性结节且符合纳入标准的患者。尽可能抽吸甲状腺囊性结节内的液体。使用18号针和99.5%乙醇进行乙醇消融，射频消融采用经峡部入路的冷电极射频消融系统和18号内部冷却电极，采用移动射击技术。评估并比较每组治疗前后的结节体积、治疗成功率、最大直径、甲状腺功能检查及并发症。
39例患者中，17例接受乙醇消融（平均年龄47.35岁；女性比例76.5%；单纯甲状腺囊肿比例41.4%），22例接受射频消融（平均年龄46.63岁；女性比例86.4%；单纯甲状腺囊肿比例54.5%）。两种治疗技术均显示最大直径和结节体积显著减小（p<0.05），且无并发症。消融后1个月，射频消融比乙醇消融在减小结节体积和最大结节大小方面更显著（p<0.05）。此外，射频消融组的治疗成功率高于乙醇消融组。
单次射频消融和乙醇消融治疗在1个月随访时均证实对甲状腺囊性结节有效且安全，射频消融在减小结节体积和最大结节大小方面比乙醇消融更显著。因此，射频消融组的治疗成功率高于乙醇消融组。
