Microwave Ablation And Surgical Resection Of Papillary Thyroid Microcarcinoma In Patients:Comparative Analysis Of Clinical Efficacy,Safety And Economy

Objective:To compare the efficacy,safety and cost between ultrasound-guided percutaneous microwave ablation and surgical resection in patients with papillary thyroid microcarcinoma.Methodology:A total of 89 patients highly suspected papillary thyroid microcarcinoma by cervical ultrasonography and pathologically were proved papillary thyroid microcarcinoma by ultrasound guided fine-needle aspiration biopsy in The Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to February 2017.49 patients were suffered microwave ablation(microwave group)while 40 patients were suffered surgical resection(surgical group).T test was used to compare operation time,the hospitalization expenses(inclouding follow-up)and the hospitalization time between the microwave group and the surgical group.Chi-squared test was applied to compare complications rate between the two groups.T test was used to compare the level of thyroid-related hormone before and after operation in the two groups.Results:In the microwave group,the operation time,the hospitalization expenses and the hospitalization time were less.[(25.73±9.46)min vs(55.85±5.05)min,(12575.48±3924.87)?vs(25707.91±5836.77)CNY,(2.92±0.78)d vs(6.78±3.03)d].These changes were statistically significant(t=-18.985?-13.084?-7.747,P<0.001).No severe complications occurred in the two groups through and after the operation.The difference of complications rate between the two groups was not statistically significant[6.1%(3/49)vs 10.0%(4/40),x2=-0.452,P=0.779].The level of 3'-triiodothyronine(FT3)and 4'-triiodothyronine(FT4)were higher after the operation in the microwave group,but these changes were not statistically significant.The level of FT3 and FT4 were lower[(4.5±0.50)pmol/L vs(3.90±0.72)pmol/L,(13.94±2.41)pmol/L vs(12.69±2.88)pmol/L],while the level of TSH was higher[(3.66±6.29)mIU/L vs(10.12±15.61)mIU/L]after operation in the surgical group.These changes were statistically significant(t=6.214,p<0.001;t=2.808,P=0.008;t=-3.035,p=0.004).Conclusions:Ultrasound-guided percutaneous microwave ablation is characterized by minimal invasion,good cosmetic effect,low cost and definite curative effect.It offered a new choice for the patients who refuse to suffer from surgical resection.