ABSTRACT Thermal ablation (TA) is a therapeutic option for benign, non-functioning thyroid nodules causing symptoms of compression and/or aesthetic concerns. TA was initially introduced as a treatment for patients who refused or were ineligible for surgery. In more recent years, the increase in the positive experiences of TA have paved the way for the idea that TA could be suggested as a first-line treatment. The present review was conceived to summarize the evidence achieved in this field, and to offer a clinical perspective on TA, with particular reference to the comparison between TA and surgery. We searched literature that was focused on two types of TA, laser (LA) and radiofrequency (RFA). The searched literature included short- mid-term prospective and retrospective studies, randomized trials, and meta-analyses that demonstrated a satisfactory volume reduction ratio (VRR), and benefits in cosmetic and symptoms scores. An important drawback of the use of TA, is the regrowth of a certain number of nodules, which necessitate further TA procedures or surgery. Long-term randomized controlled trials to evaluate the cost/effectiveness of TA vs surgery are not currently available. The selection of the nodule, the optimization of interventional techniques, and ultimately, a well-timed second treatment, are all factors that should be considered in a proactive strategy to prevent TA failure.

中文翻译：

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良性、无功能甲状腺结节的热消融：临床综述侧重于结果、技术评论和与手术的比较

摘要 热消融 (TA) 是良性、无功能甲状腺结节的一种治疗选择，可引起压迫症状和/或美学问题。TA 最初是作为对拒绝或不符合手术条件的患者的治疗而引入的。近年来，TA 积极体验的增加为 TA 可作为一线治疗的想法铺平了道路。本综述旨在总结该领域取得的证据，并提供 TA 的临床观点，特别是参考 TA 与手术之间的比较。我们检索了专注于两种类型 TA、激光 (LA) 和射频 (RFA) 的文献。检索的文献包括中短期前瞻性和回顾性研究、随机试验、和荟萃分析证明了令人满意的体积减少率 (VRR)，以及美容和症状评分的益处。使用 TA 的一个重要缺点是一定数量的结节再生，这需要进一步的 TA 程序或手术。目前还没有评估 TA 与手术的成本/效果的长期随机对照试验。结节的选择、介入技术的优化以及最终适时的二次治疗，都是预防 TA 失败的主动策略中应考虑的所有因素。目前还没有评估 TA 与手术的成本/效果的长期随机对照试验。结节的选择、介入技术的优化以及最终适时的二次治疗，都是预防 TA 失败的主动策略中应考虑的所有因素。目前还没有评估 TA 与手术的成本/效果的长期随机对照试验。结节的选择、介入技术的优化以及最终适时的二次治疗，都是预防 TA 失败的主动策略中应考虑的所有因素。