Comparison Of Ultarsound-guided Thermal Ablation And Surgery For Low-risk Papillary Thyroid Microcarcinoma

Objective:The clinical and follow-up data of patients with papillary thyroid microcarcinoma treated by ablation in 2015 were retrospectively analyzed,and compared with those undergoing surgical treatment,to explore the safety and effectiveness of ablation in the treatment of low-risk papillary thyroid microcarcinoma.Methods:A retrospective analysis of low-risk papillary thyroid microcarcinoma patients diagnosed and treated in the same treatment group in the Thyroid Surgery Department of the China-Japanese Friendship Hospital of Jilin University from January 2015 to December2015 included 118 cases in the surgical group and 132 cases in the ablation group.Summarize and analyze the characteristics of preoperative clinical data and thyroid function.The two groups of patients were followed up to compare local recurrence,lymph node and distant metastasis,and the occurrence of complications,including recurrent laryngeal nerve injury,thyroid dysfunction,parathyroid injury,pain,hematoma,etc.The volume and disappearance time of the ablation area in the ablation group were analyzed.Results:1.Basic clinical data: There were 132 patients in the ablation group,with an average age of 41.55±8.861 years(25-66 years),including 33 males and 99 females.There were 118 patients in the operation group,with an average age of 43.62±8.169 years(30-65 years),including 21 males and 97 females.Preoperative thyroid function examination showed that the thyroid function of the two groups of patients was within the normal range.2.Postoperative pathology in the surgical group: Of the 118 patients in the surgical group,25(21.2%)patients had thyroid cancer and cervical lymph node metastasis,all of which were central lymph node metastases.In another 2 cases(1.7%),occult thyroid cancer foci were found after operation,and the size of the occult foci was 0.1 cm.3.Comparison of postoperative recurrence and metastasis: The average follow-up time of patients in the operation group was 48.1±12.8months,and the follow-up rate was 74.3%,and the average follow-up time of patients in the ablation group was 35.3±10.9 months,and the follow-up rate was 91.7%.During the follow-up process of patients in the ablation group and the operation group,no tumor recurrence was found in the ablation area,new tumors in other areas and cervical lymph node metastasis,and there was no difference in the recurrence and metastasis of the two groups.4.Comparison of postoperative complications and thyroid function: There were no serious complications such as recurrent laryngeal nerve injury and parathyroid function injury in the operation group and the ablation group.All 118 patients in the operation group had hypothyroidism and were treated with Oral.The daily dose of Oral was85.77±21.98 micrograms.In the ablation group,1 case(0.7%)developed hypothyroidism and was treated with Oral Eugenol,and 3 cases(2.3%)developed hyperthyroidism and were treated with Oral Saizhi.In addition,compared with surgical treatment,ablation treatment does not produce scars and has a good cosmetic effect.5.Absorption of the ablation area in the ablation group: 121 of the 132 patients in the ablation group had complete follow-up data.The volume of the thyroid ablation area increased significantly on the 1st day and 1 month after the operation,and gradually decreased in the subsequent process.At 6 months postoperatively,37 patients(30.6%)had the ablation area disappeared.At 12 months after surgery,75 patients(62.0%)had the ablation area disappeared.As of the most recent followup,the ablation area of 121 patients had disappeared.Conclusions:1.After the ablation of low-risk papillary thyroid microcacinoma,the ablation area is well absorbed,and there is no significant difference between ablation and surgery in the occurrence of complications,local recurrence,indicating that ablation therapy is safe and effective to a certain extent.2.Despite rigorous preoperative evaluation of low-risk papillary thyroid microcacinoma,there are still multiple foci and metastatic lesions,so the indications should be carefully considered when selecting ablation therapy.3.Ablation therapy can be used as another option for the treatment of low-risk papillary thyroid microcacinoma.