|
|
Comparative study of ultrasound-guided percutaneous microwave ablation and endoscopic thyroidectomy for thyroid papillary microcarcinoma |
SHEN Yan, CAI Xiao-yan, DONG Jiang-nan, LIU Miao, HE Jie, WAN Yong-lin, WU Shu, DING Jun, FU Xiao-hong |
Gongli Hospital, Pudong New Area, Shanghai City, Shanghai 200135, China |
|
|
Abstract Objective: To evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation(US-PMWA) in papillary thyroid microcarcinoma(PTMC), and compare with endoscopic surgery(ET). Methods: Twenty patients with US-PMWA were analyzed retrospectively. Conventional ultrasound, contrast-enhanced ultrasound and thyroid function tests were performed at 1-, 3-, 6- and 12- months to evaluate the efficacy and safety of US-PMWA. Thirty-eight patients underwent endoscopic thyroidectomy for PTMC. The postoperative hospital stay, cost, and complications were compared with each other in two groups. Results: The volume of 20 nodules with US-PMWA reduced during follow-up. No suspicious metastatic lymph nodes were found in the neck. The thyroid function indexes were within normal reference range before and after microwave ablation. The average hospital-stay days, hospitalization costs and complication rate with US-PMWA were (1.70±0.57) days, (14 695.45±1 637.35) yuan and 5.0%(1/20). The hospital-stay days, hospitalization costs and complication rate with ET were (4.78±1.03) days, (20 596.71±2 192.25) yuan and 10.53%(4/38). The hospitalization days and costs were different between two groups(P<0.05), whereas the complication rate was not(P>0.05). Conclusion: With its minimally invasion, beauty and convenience, US-PMWA is suitable for PTMC without lymph nodes and distant metastasis.
|
Received: 09 August 2018
|
|
|
|
|
[1]Hedinger C, Dillwyn Williams E, Sobin LH. The WHO histological classification of thyroid tumors: a commentary on the second edition[J]. Cancer, 1989, 63(5): 908-911.
[2]Davies L, Welch HG. Current thyroid cancer trends in the United States[J]. JAMA Otolaryngol Head Neck Surg, 2014, 140(4): 317-322.
[3]康维明,吴恋,健春,等. 北京协和医院1986~2012年甲状腺疾病手术患者甲状腺疾病谱回顾性临床资料分析[J]. 中国医学科学院学报,2013,35(4):386-392.
[4]王建彬,梁萍,于杰,等. 超声引导经皮微波消融治疗老年结直肠癌肝转移[J]. 中国超声医学杂志,2014,30(5):440-443.
[5]中华医学会内分泌学会,中华医学会外科学分会,中国抗癌协会头颈肿瘤专业委员会,等. 甲状腺结节和分化型甲状腺癌诊治指南[J]. 中国肿瘤临床,2012,39(17):1249-1272.
[6]Haugen BR, Alexander EK, Bible KC, et al. American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid, 2016, 26(1): 1-133.
[7]Ito Y, Miyauchi A, Oda H. Low-risk papillary microcarcinoma of the thyroid: A review of active surveillance trials[J]. Eur J Surg Oncol, 2018, 44(3): 307-315.
[8]Glover AR, Gundara JS, Norlén O, et al. The pros and cons of prophylactic central neck dissection in papillary thyroid carcinoma[J]. Gland Surg, 2013, 2(4): 196-205.
[9]杨映弘,吴晓莉,颜璟,等. 超声引导下微波消融治疗甲状腺良性结节例报告[J]. 中国微创外科杂志,2016,16(4):313.
[10]丁千,张梅,刘灿. 超声引导下微波消融治疗甲状腺良性结节的疗效评价及短期随访[J]. 临床超声医学杂志,2016,18(6):397-400.
[11]Yue W, Wang S, Wang B, et al. Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: Safety and imaging follow-up in 222 patients[J]. Eur J Radiol, 2013, 82(1): e11-e16.
[12]Yue W, Wang S, Yu S, et al. Ultrasound-guided percutaneous microwave ablation of solitary T1N0M0 papillary thyroid microcarcinoma: initial experience[J]. Int J Hyperthermia, 2014, 30(2): 150-157.
[13]马芳花,黄品同,戚瑞祥,等. 超声引导下微波消融治疗甲状腺微小乳头状癌与外科手术切除的研究[J]. 中国超声医学杂志,2017,33(5):399-402.
[14]胡越,高毅娜,陈宝定,等. 甲状腺结节微波消融治疗对甲状腺功能的近期影响[J]. 江苏大学学报:医学版,2015,25(3):274-276.
[15]刘玉辉,孙均,王松涛,等. 老年人甲状腺结节手术切除和微波消融临床疗效和安全性对比分析[J]. 介入放射学杂志,2013,25(1):44-47.
[16]中华内分泌协会. 甲状腺结节和分化型甲状腺癌诊治指南[J]. 中华内分泌代谢杂志,2012,28(10):779-797. |
|
|
|