The Efficacy And Related Factors Of Microwave Ablation In The Treatment Of Benign Thyroid Nodules

ObjectiveThis study planned to explore the efficacy and related risk factors of microwave ablation in the treatment of benign thyroid nodules by analyzing the relationship between clinical data of patients,different ultrasonic characteristics of benign thyroid nodules and nodule’s volume reduction rate,complication rate,and recurrence rate.MethodsBy retrospectively analyzing the related information about 125 patients with 175 thyroid nodules who underwent ultrasound-guided microwave ablation treatment in our hospital from January 2018 to March 2020.The clinical data of patients and ultrasonic characteristics of benign thyroid nodules were recorded before microwave ablation.By observing the dynamic change trend of thyroid nodules size,the volume reduction rate,complication rate and recurrence rate were calculated at 1,3,6,and 12 months after surgery,respectively.Thyroid function was re-examined at first month after operation,and cosmetic score was re-evaluated at sixth month after operation.The nodules were divided into two groups according to whether the volume reduction rate higher than 80%and whether nodule recurred at twelfth month after operation,respectively.The differences of clinical data and ultrasonic characteristics between groups were compared,which to explore the effectiveness,safety and related factors of microwave ablation in the treatment of benign thyroid nodules.Univariate analysis and multivariate logistic regression analysis were carried out to determinate the independent risk factors about efficacy of microwave ablation in the treatment of benign thyroid nodules.Result1.The volumes of thyroid nodules were diminishing along with the change of follow-up time gradually,and the volume reduction rates were 47.62%,71.63%,84.44%,and 93.20% at 1,3,6,and 12 months after microwave ablation respectively,which were statistically significant compared with previous results(P<0.001).There was no statistically significant difference in the change of thyroid function(P>0.05),while the cosmetic score was significant reduced compared with that before surgery(P<0.001).The complication rate was 2.29%(4/175),including three severe pain and one hoarseness occurred.In addition,the recurrence rate of microwave ablation was 8.57%(15/175).2.In the comparison of the satisfaction of thyroid nodules’ volume reduction rate,mainly cystic nodules were 96.2%,while mainly solid nodules were 81.1%.initial volume <9 cm~3 and ≥9 cm~3 groups were 82.9% and 46.2%,respectively.The difference was statistically significant(P<0.05).There was no significant difference in volume reduction rate among the patients’ gender,age,vascularity and location of nodules(P>0.05).3.The recurrence rate became higher when patients who were younger than 50 years old,or nodules which were mainly solid nodules,initial volume larger than 9 cm~3,vascularity score above 3 and risk score of location above grade III,the recurrence rate were 13.1%,11.5%,30.8%,28.6%,21.4%,separately,and the differences were all statistically significant(P<0.05).Nevertheless,there was no significant difference in recurrence rate between patient’s gender(P>0.05).Binomial logistic regression analysis showed that the vascularity was an independent factor in predicting recurrence(P<0.05).Conclusion1.Microwave ablation is a safe and effective treatment for benign thyroid nodules which can significantly relive cosmetic problems and do not affect thyroid function.2.The composition and initial volume of nodules are related to the effectiveness of microwave ablation.The effectiveness is better when it comes to mainly cystic nodules and smaller solid nodules.3.Age,composition,initial volume,vascularity and location of nodules are related to the safety of microwave ablation.Younger people,nodules that are mainly solid,larger,hypervascularity or located in more dangerous position will be more likely to relapse.Furthermore,the vascularity is a independent factor of recurrence in thyroid nodules after microwave ablation.