Radiofrequency ablation of thyroid nodules: prospective cost-effectiveness analysis in comparison to conventional thyroidectomy

ABSTRACT Objective: The objective of this study is to compare the total costs of surgery and radiofrequency (RF) ablation for the treatment of benign thyroid nodules. Materials and methods: This is a prospective randomized study comparing cases treated with US-guided RF ablation (cases) and surgery (control). They were selected and allocated to groups (thyroidectomy or radioablation) by permuted block randomization in blocks of five cases each. Results: Five cases of RF Ablation were compared with five cases of thyroidectomies conducted in the same period. Similar complication rates were observed in both groups. Shorter operating time and hospital stay were observed for the RF group. In the evaluation of the total cost between procedures, radioblation represented 76% of the cost of partial thyroidectomy. Conclusion: This study demonstrated that radioablation has a competitive cost, making it an effective alternative in the treatment of benign thyroid nodules.

Transoral endoscopic thyroidectomy vestibular approach: initial experience and comparison with conventional thyroid surgery

Introduction: Recent interest of physicians and patients to prevent scars in the neck in thyroid surgery has fostered the development of several remote access techniques in recent decades. Among the various techniques developed, transoral endoscopic thyroidectomy vestibular approach (TOETVA) has shown to be a safe alternative, in selected cases, to conventional thyroidectomy. Objective: This study aimed to evaluate the results of TOETVA in patients with thyroid nodules and compare them with those in patients undergoing conventional thyroidectomy. Methods: Retrospective cohort study comparing 31 patients submitted to endoscopic versus 30 conventional thyroidectomies, regarding operative time, complications and pain scale. Results: Thirty-one cases of TOETVA were compared with 30 conventional thyroidectomies conducted in the same period in a tertiary care center. Similar complication rates were observed in both groups, with shorter operative time for endoscopic surgery compared with that of traditional access. Conclusion: TOETVA can be safely performed in selected cases, with similar complication rates, and shorter operative time compared with conventional thyroidectomy.