Different Approachs To Ablate Thyroid Nodules Located In The Lower-inner Quadrant:Analysis Of Safety And Efficacy

ObjectiveTo compare the security and therapeutic efficacy of the trans-isthmic approach and the lateral cervical approach to ultrasound-guided microwave ablation in treatment of benign thyroid nodules located in the lower-inner quadrant.MethodsTotal 127 patients with 142 benign thyroid nodules located in the lower-inner quadrant treated with ultrasound-guided microwave ablation were retrospectively analyzed,including 83 nodules ablated by trans-isthmic approach and 59 ablated by lateral cervical approach.The volume of 2% lidocaine,the volume of liquid isolating region,the ablation time,intraoperative pain score,complications,symptom score,cosmetic score,therapeutic success rates,and nodule volume reduction ratios were compared between the two groups to evaluate the security and therapeutic efficacy.ResultsBetween the two groups,no significant differences were found in the volume of 2% lidocaine,the volume of liquid isolating region,the ablation time,intraoperative pain score,and the complications occurred after treatment,as well as the symptom scores,cosmetic scores,and therapeutic success rates at 1,3,6,12 months(P>0.05)after treatment.Nodule volume reduction ratios of lateral cervical approach group were(47.90±20.96)% and(64.56±17.43)%,while the trans-isthmic approach group were(44.63±23.08)%,(61.01±19.94)% at 1 and 3 months after treatment.No significant differences were found between the two groups in nodule volume reduction ratios end points at 1,3 months after therapy(P>0.05).However,6 months after treatment,nodule volume reduction ratios of lateral cervical approach group were(78.13±12.69)%,while the trans-isthmic approach group were(73.07±15.71)%(P=0.036).Twelve months after treatment,nodule volume reduction ratios were(88.09±8.58)%,(84.80±9.75)% respectively(P=0.035).ConclusionThe trans-isthmic approach and the lateral cervical approach used in ultrasound-guided microwave ablation were both safe and effective technique for the treatment of benign thyroid nodules located in the lower-inner quadrant,and had equal security.The lateral cervical approach group had better nodule volume reduction ratios than the trans-isthmic approach group at 6,12 months after microwave ablation.For these nodules,the lateral cervical approach can be considered in ultrasound-guided microwave ablation.