The influence of microwave ablation on the thyroid function in treating nodular goiter / 介入放射学杂志

ABSTRACT

Objective Through comparing ultrasound-guided microwave ablation (MWA) with surgical resection for the treatment of nodular goiter to evaluate the effect of RFA on the thyroid function.Methods A total of 50 patients with nodular goiter,who were admitted to authors' hospital during the period from January 2010 to January 2013 to receive ultrasound-guided MWA,were selected and used as the study group;and other 96 patients with nodular goiter,who were encountered at authors' hospital during the same period to receive partial thyroidectomy,were collected and used as the control group.Of the 50 patients in the study group,RFA of unilateral lobe nodules was performed in 8 and RFA of bilateral lobe nodules in 42.Among the 96 patients in the control group,unilateral lobe nodules were seen in 52 and bilateral lobe nodules in 44.Postoperative complications were recorded,the serum FT3,FT4,TSH levels were determined at one week,as well as one,3,6 and 12 months after the treatment.The results were statistically analyzed.Results All patients were followed up for 12 months.In the study group,no complications occurred;one week after RFA the serum FT3 and FT4 levels increased while the serum TSH level decreased when compared with preoperative ones,and the differences were statistically significant (P＜0.05).In the control group,bleeding asphyxia occurred in one patient,hoarseness in 5 patients and hypocalcemia convulsion in 3 patients.One week after partial thyroidectomy,the serum FT3 and FT4 levels increased while the serum TSH level decreased when compared with preoperative data,and the differences were statistically significant (P＜0.05).One week after surgery thyroxine replacement therapy was routinely given to 44 patients who had received bilateral subtotal thyroidectomy.Three patients who had received unilateral subtotal thyroidectomy developed hypothyroidism at 3,6 and 8 months after the surgery respectively.In other 49 patients receiving unilateral subtotal thyroidectomy the serum FT3,FT4,TSH levels determined at one,3,6 and 12 months after surgery were significantly different from those in the patients of the study group (P＜0.05).Conclusion For the treatment of nodular goiter,ultrasound-guided MWA is quite safe.MWA has very slight effect on thyroid function and is definitely superior to subtotal thyroidectomy.Therefore,MWA is a minimally invasive technique which is worthy of clinical promotion.