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Comparison of Microwave Ablation and Lobectomy in the Treatment of Benign Thyroid Nodules
Saim Turkoglu1, Abdullah Hilmi Yilmaz2, Adem Yokus1
1Department of Radiology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey.
Purpose:
The purpose of this study is to evaluate the efficacy, safety, and advantages of microwave ablation (MWA) compared to lobectomy in the treatment of benign thyroid nodules.
Methods:
A total of 105 patients were included in the study, 49 in the MWA group and 56 in the surgical group. The mean age of the patients in the MWA group was 49.5 (±12.8) and 40.2 (±10.1) in the surgical group (p < 0.001). 81.6% of the patients in the MWA group were female and 18.4% were male. 83.9% of the patients in the surgical group were male and 16.1% were female (p = 0.75). Patients were followed for at least 12 months. The study was completed by comparing the two groups in terms of surgery-procedure times, complications, nodule sizes, thyroid function tests, symptoms, volume reduction rates (VRR), and cosmetic improvement scores.
Results:
The mean maximum nodule diameter in the patient group who underwent MWA was 3.5 (±1) cm at the beginning and 2.3 (±0.9) cm at the end of the 12th month (p < 0.001). VRR was 73.4% (±14.8) at the end of the 12th month (p < 0.001). Cosmetic score was 2.5 (±1) at the first month, 1.7 (±1.1) at the third month, 1 (±1) at the sixth month, and 0.6 (±0.7) at the 12th month (p < 0.001). The procedure time was 15.4 (±4.4) minutes in the patients in the MWA group, while it was 70.7 (±17.2) minutes in the surgical group (p < 0.001). No complications developed in 48 patients (98%) in the MWA group and 38 patients (67.9%) in the surgical group (p = 0.005). Voice change occurred in three patients (5.4%) in the surgical group, hematoma in two (3.6%) patients and voice change in one (1.8%) patient in the MWA group. Hypothyroidism developed in eight patients in the surgical group, while hypothyroidism did not develop in the MWA group (p = 0.007).
Conclusion:
MWA is a safe and effective treatment method for benign thyroid nodules. It has many advantages over thyroidectomy, such as fewer complications, shorter procedure time, no need for hospitalization and general anesthesia, and good cosmetic results.
Clinical Significance:
Compared with surgery, MWA is a safe, effective, and cost-effective treatment for benign thyroid nodules.
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