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Post a Comment Laser-induced thermotherapy of thyroid nodules with ablation of vessels feeding the nodule
- Authors: Petrov V.G.1, Sozonov A.I.1, Baksheev E.G.1, Ivashina E.G.2, Ermakova A.A.1, Ermakova P.A.1
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Affiliations:
- Tyumen State Medical University
- Multidisciplinary Consultative and Diagnostic Center
- Issue: Vol 39, No 5 (2022)
- Pages: 93-103
- Section: Methods of diagnosis and technologies
- URL: https://journal-vniispk.ru/PMJ/article/view/112486
- DOI: https://doi.org/10.17816/pmj39593-103
- ID: 112486
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Abstract
Objective. To improve the results of treatment in patients with benign nodular pathology of the thyroid gland (TG) by means of perfecting the technique of minimally invasive treatment with a high-intensive laser under the sonographic control.
Materials and methods. An original technique of laser-induces thermotherapy (LITT) of the thyroid nodule with the ablation of the vessels, feeding the nodule was developed and introduced. The procedure was used in the treatment of 91 patients with benign nodular pathology of the thyroid gland, 116 patients underwent laser-induced thermotherapy by the standard technique (comparison group). Three months later, US was used to assess and compare the results of treatment in both groups. The results of thermometry were analyzed depending on the initial volume of the TG nodular neoplasm.
Results. A decrease in the nodules with the initial volume up to 2 cm3 in both groups was statistically significant and took place practically similarly – 78.7 % in the main group and 71.7 % in the comparison group. When exposing the nodules of larger sizes, the efficiency of standard LITT method fell. In the comparison group, patients with the nodular sizes of 6–8 cm2 had a decrease in the volume only by 25.8 % % (from 6.74 cm3 to 5.0 cm3). When using an original method of thermoablation (TA), a decrease in the nodules of the same size was 69.3 % (from 6.98 cm3 to 2.14 cm3). The difference was statistically significant (p = 0,003) that proves the efficiency of this technique. In the subgroup with the nodules > 8 cm3, a nodular volume decrease was 33.3 % (from 11.05 to 7.36 cm3) in the main group and 28.8 % (from 14.07 to 10.02 cm3) in the comparison group. The difference was not statistically significant (p = 279).
Conclusions. Laser-induces thermotherapy of the thyroid gland with the ablation of the vessel, feeding the nodule, leads to a statistically significant reduction of the benign colloid nodular neoplasms of any size. The original technique indicated higher efficiency compared with standard LITT in relation to the nodules sized from 6 to 8 cm.
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##article.viewOnOriginalSite##About the authors
V. G. Petrov
Tyumen State Medical University
Author for correspondence.
Email: v_doc@mail.ru
MD, PhD, Professor, Department of Surgical Diseases with Course of Endoscopy and Ophthalmology
Russian Federation, TyumenA. I. Sozonov
Tyumen State Medical University
Email: v_doc@mail.ru
Candidate of Medical Sciences, Associate Professor, Department of Public Health and Healthcare
Russian Federation, TyumenE. G. Baksheev
Tyumen State Medical University
Email: v_doc@mail.ru
postgraduate student, Department of Surgical Diseases with Course of Endoscopy and Ophthalmology
Russian Federation, TyumenE. G. Ivashina
Multidisciplinary Consultative and Diagnostic Center
Email: v_doc@mail.ru
endocrinologist
Russian Federation, TyumenA. A. Ermakova
Tyumen State Medical University
Email: v_doc@mail.ru
student, Faculty of Medicine
Russian Federation, TyumenP. A. Ermakova
Tyumen State Medical University
Email: v_doc@mail.ru
student, Faculty of Medicine
Russian Federation, TyumenReferences
- Privalov V.A., Seliverstov O.V., Revel-Muroz Zh.A. et al. Percutaneous laser-induced thermotherapy of nodular goiter. Hirurgija 2001; 1: 10–13 (in Russian).
- Achille G., Zizzi S., Di Stasio E. et al. 18solid benign thyroid nodules: Our experience in 45 patients. Head Neck. 2014.
- Gharib H., Papini E., Garber J.R. et al. American Association of Clinical Endocrinologists, American College of Endocrinologists, Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules – 2016 update appendix. Endocr Pract. 2016; 22 (1): 1–60.
- Cesareo R., Palermo A., Pasqualini V. et al. Radiofrequency ablation for the management of thyroid nodules: a critical appraisal of the literature. Clin Endocrinol (Oxf) 2017; 87: 639–648.
- Pacella C.M., Bizzarri G., Guglielmi R. et al. Thyroid tissue: US-guided percutaneous interstitial laser ablation-a feasibility study. Radiology 2000; 217: 673–677.
- Jeong W.K., Baek J.H., Rhim H. et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol 2008; 18: 1244–1250.
- Papini E., Guglielmi R., Bizzarri G. et al. Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up. Thyroid 2007; 17: 229–235.
- Deandrea M., Limone P., Basso E. et al. US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules. Ultrasound Med Biol 2008; 34: 784–791.
- Bernardi S., Dobrinja C., Fabris B. et al. Radiofrequency ablation compared to surgery for the treatment of benign thyroid nodules. Int J Endocrinol 2014; 2014: 934595.
- Radzina M., Cantisani V., Rauda M. et al. Update on the role of ultrasound guided radiofrequency ablation for thyroid nodule treatment. Int J Surg 2017; 41 Suppl 1: 82–93.
- Mauri G., Pacella C.M., Papini E. et al. Proceedings of the first Italian conference on thyroid minimally invasive treatments and foundation of the Italian research group for thyroid minimally invasive procedures. Int J Hyperthermia 2018; 34: 603–605.
- Ha E.J., Baek J.H., Kim K.W. et al. Comparative efficacy of radiofrequency and laser ablation for the treatment of benign thyroid nodules: systematic review including traditional pooling and bayesian network meta-analysis. J Clin Endocrinol Metab 2015; 100: 1903–1911.
- Lim H.K., Lee J.H., Ha E.J. et al. Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur Radiol 2013; 23: 1044–1049.
- Baek J.H., Lee J.H., Valcavi R. et al. Thermal ablation for benign thyroid nodules: radiofrequency and laser. Korean J Radiol 2011; 12: 525–540.
- Sim J.S., Baek J.H., Lee J. et al. Radiofrequency ablation of benign thyroid nodules: depicting early sign of regrowth by calculating vital volume. Int J Hyperthermia 2017 33: 905–910.
- Døssing H., Bennedbæk F.N., Hege- düs L. Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules. Eur J Endocrin. 2011; 165 (1): 123–128.
- Wang B., Han Z.Y., Yu J. et al. Factors related to recurrence of the benign non-functioning thyroid nodules after percutaneous microwave ablation. Int J Hyperthermia 2017; 33: 459–464.
- Baek J.H., Lee J.H., Sung J.Y. et al. Complications encountered in the treatment of benign thyroid nodules with US-guided radiofrequency ablation: a multicenter study. Radiology 2012; 262: 335–242.
- Kim C., Lee J.H., Choi Y.J. et al. Complications encountered in ultrasonography-guided radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers. Eur Radiol 2017; 27: 3128–3137.
- Park H.S., Baek J.H., Park A.W. et al. Thyroid radiofrequency ablation: updates on innovative devices and techniques. Korean J Radiol 2017; 18: 615–623.
- Aleksandrov Yu.K., Sevenko E.I., Yanovskaya M.E. Possibilities of interstitial laser photocoagulation in the treatment of patients with subcentimeter thyroid nodules. Modern aspects of surgical endocrinology. Proceedings of the XIX Russian Symposium with International Participation. Chelyabinsk 2010; 15–17 (in Russian).
- Cesareo R., Pasqualini V., Simeoni C. et al. nni, Prospective Study of Effectiveness of Ultrasound-Guided Radiofrequency Ablation Versus Control Group in Patients Affected by Benign Thyroid Nodules, J Clin Endocrinolog Metab. 2015; 100 (2): 460–466.
- Deandrea M., Trimboli P., Garino F. et al. Long-Term Efficacy of a Single Session of RFA for Benign Thyroid Nodules: A Longitudinal 5-Year Observational Study. J Clin Endocrinol Metab. 2019, 104 (9): 3751–3756.
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