| Objectives:The aim of this study is to compare Efficacy and safety of radiofrequency ablation versus operation for overmuch residual thyroid removal before 131I treatment in differentiated thyroid cancer.Methods:Clinical data from 52 newly diagnosed differentiated thyroid cancer patients who treated with operation at Zhejiang Cancer Hospital from January 2014 to December 2016 were retrospectively reviewed.The serum TSH<30 IU/ml,99mTc thyroid imaging and ultrasound examination showed obviously residual thyroid tissue after 3 weeks of low iodine diet and discontinuation of euthyrox.The inclusion criteria were as follows:(1)no lymph node metastasis was found in postoperative imaging;(2)for patients,131I treatment is necessary;(3)the clinical,imaging and laboratory results all considered that there were too many thyroid residues;(4)all patients underwent radiofrequency ablation or surgical resection;(5)case information is complete;(6)patients were able to understand and communicate without obstacles.The exclusion criteria were as follows:(1)serious heart and lung diseases;(2)severe coagulation dysfunction;(3)the other side vocal cord function is normal;(4)follow-up exfoliation.The study was examined and approved by the ethics committee of our hospital.All patients and their families had informed consent and signed informed consent.Of these patients,28 cases received radiofrequency,while 24 cases treated with operation.The operation time,the waiting time of 131I treatment and the efficacy of residual thyroid tissue clearance were compared by t-test between two groups.At the same time,we used chi-square test to compare the complications between the two groups were observed.Results:The mean values of operation time between two groups were(22.14±7.12)min and(55.45±13.56)min,respectively,and there was a statistical difference(t=11.822,P<0.05).The mean waiting time of 131I treatment in patients received radiofrequency was(9.40±4.14)days,while the mean waiting time in operation group was(13.53±4.55)days,and the differences were statistically significant(t=9.144,p<0.05).In RFA group,hoarseness,temporary parathyroid injury and permanent parathyroid injury were observed in 2 cases,0 cases and 1 cases,respectively.While there were 2 cases,3 cases and 0 cases in the operative group.There were no significant differences between the two groups(p>0.05).85.7%(24/28)of patients in RFA group and 91.7%(22/24)in operation group experienced favorable efficacy of residual thyroid removal,and there were no significant differences between the two groups(p>0.05).Conclusion:Compared with operation,postsurgical residual thyroid tissue removal in differentiated thyroid cancer using radiofrequency ablation by ultrasound guided is safe and effective,and provides a new minimally invasive treatment for patients who are reluctant to undergo surgery.We should also attach great importance to the potential complications of RFA,especially the injury of parathyroid glands is random.It is difficult to take effective measures to avoid it.At this point,we should consider the overall situation of tumor treatment,repeatedly weigh the need for radiofrequency ablation,to ensure that patients have full right to know and the right to choose. |
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