Randomized Clinical Trial of Ultrasound-Guided Microwave Ablation Combined With Lauromacrogol Ablation of Thyroid...

Thyroid cystic-solid nodules are common thyroid disorders. Ultrasound-guided microwave ablation (MWA) is widely used to treat benign nodules; however, its efficacy remains limited for larger nodules when used alone. While lauromacrogol ablation (LIA) can effectively address cystic nodules, the clinical value of combining MWA with LIA remains unclear. This randomized clinical trial aims to evaluate the treatment efficacy of ultrasound-guided MWA combined with LIA in treating thyroid cystic-solid nodules and to evaluate its association with thyroid function indices.

A single-center randomized clinical trial was conducted, and a total of 88 patients with thyroid cystic-solid nodules were selected from January 2022 to January 2024 and randomly divided into two groups: the MWA group (44 cases, treated with MWA alone) and the MWA + LIA group (44 cases, treated with MWA combined with LIA). Procedure-related parameters, volume reduction rate, thyroid function indicators including thyroid stimulating hormone, free triiodothyronine, and free thyroxine, symptom scores, cosmetic scores, and complication rates were compared between groups. Patients were followed for 12 mo to assess efficacy and safety. Pearson correlation analysis was used to evaluate the relationship between procedure-related parameters and treatment outcomes.

Volume reduction rate in the MWA + LIA group at 6 and 12 mo postoperatively was significantly higher than that in the MWA group (both P < 0.05), and the ablation time and energy consumption per unit volume were lower than those in the MWA group (P < 0.05). Subgroup analysis showed that the combined treatment was more effective for predominantly cystic nodules (P < 0.05). There were no apparent changes in thyroid function indicators in either group postoperatively (P > 0.05). The symptom scores, cosmetic scores, and overall complication rate (13.64% vs. 34.21%) in the MWA + LIA group were lower than those in the MWA group (P < 0.05). Correlation analysis indicated that ablation time and energy per unit volume were negatively correlated with treatment efficacy (P < 0.05).

Ultrasound-guided MWA combined with LIA is associated with higher treatment efficacy for thyroid cystic-solid nodules, particularly effective for predominantly cystic nodules. This approach is associated with fewer complications, higher safety profiles, and no obvious alterations in thyroid function indices, compared to MWA alone. Future studies should include larger sample sizes and longer follow-up to validate long-term outcomes.