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[Long-term results of ultrasound-guided ethanol injections in patients with autonomous thyroid nodules and
1Klinik für innere Medizin, Krankenhaus Burg, Akademisches Lehrkrankenhaus der Otto-von-Guericke-Universität Magdeburg. p.janowitz@kreiskrankenhaus-burg.de
Aim:
The aim of this study was to evaluate the long-term efficacy of treatment of autonomous thyroid nodules with percutaneous ethanol injection under ultrasound guidance.
Patients And Methods:
In a period of 56 months, 20 patients (13 women and seven men, mean age 67.5 +/- 12.3 years) with autonomous toxic thyroid nodules were treated with percutaneous ethanol injection under ultrasound guidance. Ethanol was injected percutaneously on an outpatient basis for a mean of 2.85 +/- 1.1 injections per patient, mainly depending on the nodule's size. The mean volume of injected ethanol was 4.63 ml. The median follow-up time was 763 +/- 452 days.
Results:
The injection was well tolerated by the patients, a mild to moderate local pain occurred in 21% of sessions. Undesirable effects were not serious and only transient and receded. Major complications like transient dysphonia or common jugular vein thrombosis have not been observed. After a mean time of 50 +/- 23 days an euthyroid state with normalized basal levels of TSH, fT3 and fT4 was maintained in 16 patients (80%), while four patients (20%) did not completely respond to the treatment. In this patients a therapy with methimazole was carried out. The rate of reduction in the nodular volume was 60.8%.
Conclusion:
The percutaneous ethanol injection appears to be an effective, harmless and low-cost alternative treatment of autonomous thyroid nodules, especially in older and multimorbid patients.
