Comparative Study On Percutaneous Microwave Ablation And Surgical Resection For Papillary Thyroid Microcarcinoma

Objective:To evaluate the clinical efficacy and safety of Ultrasound-guided percutaneous microwave ablation and surgical resection for papillary thyroid microcarcinoma.Methodes:65 patients who were admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine with ultrasound guided fine-needle aspiration biopsy(FNAB)pathologically proven thyroid papillary carcinoma,have nodules of diameter<1.0cm.Preoperative ultrasound exclusion patients who were unsuitable for microwave ablation treatment,according the size?shape?location?boundary?calcification?hardness(elastic score)and blood supply of nodules(CDFI and ultrasonography perfusion model),whether there is suspicious metastatic lymph node in the neck,and suspicious metastasis in all organs.Before the operation,all patients were told the curative effect of microwave ablation and surgical resection,the complications and the advantages and disadvantages,then,sign the informed consent form.In the end,all of them have been divided into two groups ccording to their preference,microwave ablation treatment group 30 cases,surgical treatment group 35 cases.Observing two groups of operation time,amount of blood loss,hospitalization days,postoperative complications,postoperative changes of thyroid-related hormone levels and tumor shrinkage after microwave ablation.Result:1.The ablation of patients receiving microwave ablation in all of 30,was successful.The average operation time was 10?30min,the amount of blood loss was 10-15ml.All of them have no tic and other serious complications,except one patient has found the voice hoarse,and recovered after a week.In 35 patients undegoing radical surgery(with lateral thyroid and isthmus resection+affected side VI lymph node dissection),the operation was successful.The average operation time was>30min,the amount of blood loss was<5ml.All of them have no tic and other serious complications,except two patients have found the voice hoarse,two patients have drank water choking cough,and recovered after three months.The postoperative complications between the two groups were not statistically significant(?2 =0.57,P=0.45).2.The postoperative thyroid function of the microwave ablation group was only slightly lower of TSH,while the surgical group TSH increased,FT4 and FT3 decreased.The differences between the two groups were statistically significant(P<0.05).3.The two groups have no recurrence and lymph node metastasis after operation.There were 10 patients have been proved metastatic lymph node in the VI region of the neck,the transport tare was 28.6%(10/35).4.The postopertative Color Doppler showed no blood flow signal in the microwave ablation group,and ultrasound showed no enhancement.The volume of nodules was 100.93±52.25mm3 after one month,and the volume was 33.61 ±49.13mm3 after three months,and the volume was 11.74±32.23mm3 after six months,the volume of nodules was significantly reduced with the passage of time.Conclusion:Ultrasound-guided percutaneous microwave ablation therapy of thyroid papillary carcinoma has advantage at trauma,biooding,operation time,hospitalization time,recovery and beauty than surgical resection,it is expected to provide a new method of minimally invasive treatment to people who have surgical contraindications or reluctant to surgery.