Abstract

Purpose

To compare the clinical outcomes of radiofrequency ablation (RFA) versus reoperation for benign thyroid nodules that developed after previous thyroid surgery.

Methods

A total of 53 patients with 53 benign nodules developed after previous thyroid surgery were evaluated in this retrospective study. Eighteen patients were treated by RFA (RFA group) and 35 patients underwent reoperation (reoperation group). The efficacy, safety, thyroid function, blood loss, hospitalization, total treatment time, and cost were compared between the two groups.

Results

In the RFA group, the mean volume decreased significantly from 12.78 ± 17.57 ml to 0.94 ± 1.01 ml (p = 0.043) with a volume reduction rate of 85.27 ± 14.35% and significant improvement in symptom and cosmetic scores (all p = 0.001). Therapeutic efficacy was achieved with a single session in all thyroid nodules. The total treatment time (6.12 ± 3.17 min vs. 110.26 ± 44.41 min, p < 0.001), blood loss (0 ml vs. 82.58 ± 105.55 ml, p < 0.001) and hospitalization(0 days vs. 9.66 ± 4.28 days, p < 0.001) were significantly lower in the RFA group than those in reoperation group, but the costs of treatment were similar(2262.12 ± 221.54 USD vs. 2638.04 ± 1062.90 USD, p = 0.081). The incidence of complications was significantly higher in the reoperation group than in the RFA group(31.43 vs. 0%, p < 0.001). Furthermorre, 65.17% of patients developed hypothyroidism after reoperation, whereas the thyroid function of the patients in the RFA group was unaffected.

Conclusion

For patients with benign thyroid nodules developed after previous thyroid surgery, RFA can be considered as a safe and effective alternative to reoperation with advantages of maintenance of intact thyroid function and low incidence of complications.

中文翻译：

---

先前甲状腺手术后出现的良性甲状腺结节的射频消融与再手术

摘要

目的

为了比较射频消融（RFA）与再次手术治疗先前甲状腺手术后出现的良性甲状腺结节的临床结局。

方法

这项回顾性研究对总共53例先前甲状腺手术后出现的53例良性结节患者进行了评估。RFA治疗18例（RFA组），再手术35例（再手术组）。比较两组的疗效，安全性，甲状腺功能，失血量，住院时间，总治疗时间和费用。

结果

在RFA组中，平均体积从12.78±17.57 ml显着下降至0.94±1.01 ml（p  = 0.043），体积减小率为85.27±14.35％，症状和美容评分显着改善（所有p  = 0.001）。一次治疗所有甲状腺结节均达到治疗效果。总治疗时间（6.12±3.17分钟vs. 110.26±44.41 min，p  <0.001），失血（0 ml vs. 82.58±105.55 ml，p  <0.001）和住院治疗（0天vs. 9.66±4.28天，p  <0.001）在RFA组中显着低于再手术组，但治疗费用相似（2262.12±221.54 USD vs. 2638.04±1062.90 USD，p = 0.081）。再次手术组的并发症发生率明显高于RFA组（31.43 vs. 0％，p  <0.001）。再者，再次手术后65.17％的患者发展为甲状腺功能减退，而RFA组患者的甲状腺功能未受影响。

结论

对于先前甲状腺手术后出现的良性甲状腺结节患者，RFA可被认为是再次手术的安全有效替代方法，具有维持甲状腺功能完整和并发症发生率低的优点。