Xu Xidong, Peng Ying, Han Guoxin
Department of Thyroid Surgery, the Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
Am J Otolaryngol. 2024 Jan-Feb;45(1):104025. doi: 10.1016/j.amjoto.2023.104025. Epub 2023 Aug 17.
Confidence in long-term treatment results of thermal ablation for benign thyroid nodules (BTNs) is required in comparison with surgery. The objective of this meta-analysis is to report 5-year follow-up results of thermal ablation for BTNs.
Ovid PUBMED, COCHRANE, and EMBASE databases were searched through Feb 30, 2023, for studies reporting outcomes in patients with BTNs treated with thermal ablation and followed up for about 5 years. Pooled volume reduction rates (VRRs) at 6, 12, 24, 36, 48, and 60 months after thermal ablation were assessed. Data were extracted and methodological quality was assessed independently by two radiologists according to the PRISMA guidelines.
Five studies, involving 939 patients, met the inclusion criteria through database searches. 137 patients experienced local nodules recurrence during a mean pooled 59.25-month follow-up. Seventeen of them proved to be non-benign. Fifty of all patients with nodules regrowth had a secondary surgery, while 35 had a secondary thermal ablation. The pooled mean major complication rate was 7.70 %, with no patient experiencing life-threatening or delayed complications.
Thermal ablation is an excellent local nodules control method in patients with BTNs, and results in a clinically significant and long-lasting volume reduction of BTNs. The risk of regrowth and needing retreatment was lower after thermal ablation.
与手术相比，需要对良性甲状腺结节（BTNs）热消融的长期治疗效果有信心。本荟萃分析的目的是报告BTNs热消融的5年随访结果。
检索截至2023年2月30日的Ovid PUBMED、COCHRANE和EMBASE数据库，以查找报告接受热消融治疗并随访约5年的BTNs患者结局的研究。评估热消融后6、12、2４、36、48和60个月的合并体积缩小率（VRRs）。根据PRISMA指南，由两名放射科医生独立提取数据并评估方法学质量。
通过数据库检索，5项研究（涉及939例患者）符合纳入标准。在平均59.25个月的合并随访期间，137例患者出现局部结节复发。其中17例经证实为非良性。所有结节复发患者中有50例接受了二次手术，35例接受了二次热消融。合并平均主要并发症发生率为7.70%，无患者发生危及生命或延迟性并发症。
热消融是治疗BTNs患者的一种出色的局部结节控制方法，可使BTNs在临床上显著且持久地缩小体积。热消融后结节复发和需要再次治疗的风险较低。
