The Comparison Of Clinical Effects Microwave Ablation And Open Surgery For The Treatment Of Benign Thyroid Nodules

Background and Objective Thyroid nodules is a common clinical disease and most of them are benign.Currently the main treatment for benign thyroid nodules is still conventional surgical resection,and the effect is significant.However,open surgical treatment need general anesthesia,so,the risk is relatively high;besides,it has a greater impact on thyroid function.In addition,open surgery may bring about significant scars,which can also affect the appearance of patients.At last,surgical complications Can not be ignored too.In recent years,microwave ablation has been used more and more in the treatment of thyroid diseases,especially the benign thyroid nodules.Through microwave ablation therapy,the volume of nodules can be significantly reduced,or even be completely absorbed,therefore the symptoms caused by nodules can be relieved.However,the effect and safety of microwave irradiation in the treatment of benign thyroid nodules need to be confirmed by more clinical studies.So,the aim of this study was to define the effectiveness and safety of ultrasound(US)-guided percutaneous microwave ablation(MWA)for benign thyroid nodules,by comparison with the surgical group.Methods A total of 100 patients with benign thyroid nodules were divided into ablation group and surgery group.The surgery group was treated by traditional open surgery,and the ablation group was treated by microwave ablation guided by ultrasound.The patients were followed up for 1 year,in this period,the thyroxine and parathyroid hormone were measured.Besides the size of nodules at 1,3,6 and 12 months after operation was evaluated by ultrasound.Results The average operation time and hospitalization time of the ablation group were significantly shorter than those in the surgical group(P<0.05),while the total cost of hospitalization was similar between the two groups(P>0.05).The amount of blood loss in the ablation group was significantly lower than that in the surgical group,and the neck scar was much smaller than the operation group.The incidence of postoperative complicationsin the ablation group was(2/50,4.0%),and(9/50,18.0%)in the operation group.Comparing the two groups,the incidence of complications in ablation group was much lower than that in operation group,the difference was statistically significant(P <0.05).Among them,3 patients in operation group had hoarseness but all were transient,and the symptoms disappeared within 2weeks after operation,without any treatment.TSH,FT3 and TT4 in ablation group did not change significantly(P> 0.05),6 months after operation,TSH and TT4,FT3 in operation group were significantly lower(P <0.05).There was significant difference in the TSH,TT4 and FT3 between radiofrequency ablation group and operation group(P <0.05)).6 months after treatment,the nodules have been significantly reduced,and even some disappeared.After 12 months,the average volume of nodules was significantly reduced(preoperative2.79 ± 0.76 vs 0.41 ± 0.42,P = 0.001);the reduction rate of nodules reached85.3% ± 15.1% and the nodule disappearance rate was close to 50%.Conclusion Traditional surgical resection and microwave ablation are all effective methods for the treatment of benign thyroid nodules.Compared with surgery,the advantages of microwave ablation are great,including fewer complications,less thyroid function,fewer days of hospitalization,and so on.Therefore,microwave ablation should be considered as first-line treatment of benign thyroid nodules.