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Efficacy and safety of ultrasound-guided microwave "Near-Total Ablation" for refractory hyperthyroidism: a
Fenglin Wu1, Shicong Song2, Junyu Xue1
1Department of Endocrine and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Objective:
The current study aims to investigate the efficacy and safety of ultrasound-guided microwave "Near-Total Ablation" in the treatment of refractory hyperthyroidism, with a particular focus on the postoperative drug-free euthyroidism rate and the incidence of hypothyroidism.
Methods:
A total of 60 patients with refractory hyperthyroidism who met the clinical diagnostic criteria for refractory hyperthyroidism were enrolled in this study. All patients underwent ultrasound-guided microwave "Near-Total Ablation" targeting the bilateral thyroid lobes and isthmus.
Results:
Of the 60 enrolled patients, 57 were included in the postoperative follow-up, while 3 were excluded. The postoperative follow-up duration ranged from 6 to 36 months, with a mean of 10.6 ± 4.6 months. During follow-up, 35 patients achieved hyperthyroidism remission (remission group), with a remission rate of 61.4%, while 22 patients had unrelieved hyperthyroidism (non-remission group), with a non-remission rate of 38.6%. In the remission group, 4 patients with decreased thyroid-stimulating hormone (TSH) and 8 patients with recurrent hyperthyroidism received one session of supplementary ablation. In the non-remission group, 18 patients received one session of supplementary ablation, 3 patients received two sessions, and 1 patient received three sessions. At the final follow-up, the remission rate of hyperthyroidism was 98.2% (56/57), with a non-remission rate of 1.8% (1/57). The rate of drug-free euthyroidism was 68.4% (39/57), and the incidence of hypothyroidism was 29.8% (17/57). The recurrence rate of hyperthyroidism was 17.5%, and the incidence of major complications was 3.5% (2/57).
Conclusion:
Microwave "Near-Total Ablation" is a safe and effective method for the treatment of refractory hyperthyroidism, with a high postoperative euthyroidism rate and a low incidence of hypothyroidism. This technique is expected to become an alternative to surgical thyroidectomy for hyperthyroidism.