Microwave ablation induces a lower systemic stress response in patients than open surgery for treatment of benign thyroid nodules

Yan, Jing; Qiu, Tihong; Lu, Jing; Wu, Yanjun; Yang, Yinghong

doi:10.1080/02656736.2018.1427286

Cited by 27 publications

(27 citation statements)

References 32 publications

(36 reference statements)

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“…It is known that microwave ablation and surgical trauma as external environmental stimuli can both cause the body’s non-infectious stress response. The size and duration of stress response after surgery reflect the severity of surgical trauma[20,21]. Therefore, lower trauma during surgery can reduce the body’s stress response.…”

Section: Discussionmentioning

confidence: 99%

Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma

Ningming

Cao

et al. 2018

WJCC

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AIM To compare the effect and postoperative trauma of ultrasound-guided percutaneous microwave ablation and surgical resection in the treatment of papillary thyroid microcarcinoma (PTMC). METHODS Eighty-seven patients with PTMC treated at Fudan University affiliated Shanghai Fifth People’s Hospital were enrolled as subjects. The patients were divided into a microwave ablation group (41 cases) and a surgical group (46 cases). The operative time, intraoperative blood loss, length of hospital stay, serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), thyroid-related hormonal changes, and complications 7 d and 30 d after surgery were observed. RESULTS The operative time, intraoperative blood loss, and length of hospital stay in the surgical group were significantly higher than those in the microwave ablation group ( P < 0.05). The levels of CRP, IL-6, and TNF-α in the surgical group were significantly higher than those in the microwave ablation group ( P < 0.05). The free triiodothyronine (FT3) and free thyroxin (FT4) levels in the surgical group were significantly lower than those in the microwave ablation group ( P < 0.05). However, the postoperative thyroid stimulating hormone (TSH) level was significantly higher than that in the microwave ablation group ( P < 0.05). There were significant interactions between the FT3, FT4, and TSH 7 d and 30 d after operation and the treatment methods ( P < 0.05). There was no significant difference in the complications between the two groups ( P > 0.05). CONCLUSION Microwave ablation for papillary microcarcinoma of the thyroid gland has less trauma to the body, quicker recovery, and no scars. It can effectively shorten the length of hospital stay and improve the quality of life of patients.

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Section: Discussionmentioning

confidence: 99%

Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma

Ningming

Cao

et al. 2018

WJCC

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“…A randomized trial in 52 patients demonstrated that MWA was followed by better general health and mental scores than thyroid surgery at 12 and 24 months [68]. In another randomized trial in 108 patients, MWA resulted in a lower visual analogue scale post-procedural pain score, and lower mean cortisol level, as a measure of stress, compared to surgery [69].…”

Section: Microwave Ablationmentioning

confidence: 99%

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

et al. 2020

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Standard therapeutic approaches for benign thyroid lesions that warrant intervention are surgery for cold and either surgery or radioiodine for autonomously functioning thyroid nodules (AFTN). Image-guided thermal ablation (TA) procedures are increasingly proposed as therapy options for selected clinical conditions. Due to mounting scientific evidence and widening availability, ETA considered it appropriate to develop guidelines for the use of TA in adult patients. TA procedures are well tolerated, but a dedicated training of the operators is required and information on possible complications needs to be shared with the patients. The following factors should be considered when weighing between observation, surgery, and TA for benign thyroid nodules. In solid non-hyperfunctioning nodules, TA induces a decrease in thyroid nodule volume, paralleled by improvement in symptoms. Nodule re-growth is possible over time and may necessitate repeat treatment, or surgery, in a dialogue with the patient. In AFTN, radioactive iodine is the first-line treatment, but TA may be considered in young patients with small AFTN due to higher probability of restoring normal thyroid function and avoidance of irradiation. In cystic nodules, ethanol ablation (EA) is the most effective and least expensive treatment. TA may be considered for cystic lesions that relapse after EA or have a significant residual solid component following drainage and EA. TA should be restricted to benign lesions that cause symptoms or cosmetic concern. Presently, laser and radiofrequency ablation are the most thoroughly assessed techniques, with similar satisfactory clinical results. Microwaves and high-intensity focused ultrasound therapy options remain to be fully evaluated.© 2020 European Thyroid Association Published by S. Karger AG, Basel Recommendation 1. In adult patients with benign thyroid nodules that cause pressure symptoms and/or cosmetic concerns and decline surgery, image-guided TA should be considered as a costand risk-effective alternative option to surgical treatment or observation alone (1, ØØOO).Recommendation 2. We recommend against the use of TA for asymptomatic lesions (1, ØØØO).

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“…Thermal ablation is an effective outpatient procedure, with high technical feasibility [6], elevated clinical success rate [7,8], low frequency of minor (0.5-4%) [7,9] and major complications (less than 3.9%) [6], and outcomes sustained up to five years [7,[44][45][46][47]. A few comparative studies between thermal ablation and open thyroidectomy showed that the former resulted in shorter operation time, no need of hospitalization, and absence of post-treatment scar [48], less complications and side effects, no functional changes, higher patients' satisfaction [48][49][50][51][52][53] and, as a whole, lower direct and longterm costs.…”

Section: Statementsmentioning

confidence: 99%

Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group

Papini

Pacella

Solbiati

et al. 2019

International Journal of Hyperthermia

162

182

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Microwave ablation induces a lower systemic stress response in patients than open surgery for treatment of benign thyroid nodules

Abstract: Microwave ablation induces a lower systemic stress response than open surgery for treatment of benign thyroid nodules.

Cited by 27 publications

References 32 publications

Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma

Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma

2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules

Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement from the Italian minimally-invasive treatments of the thyroid (MITT) group

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