AN TOÀN VÀ HIỆU QUẢ CỦA ĐỐT NHÂN GIÁP LỚN LÀNH TÍNH BẰNG VI SÓNG (MWA)

SUMMARY

Most thyroid nodules are benign and do not require treatment, but large (≥3 cm) benign thyroid nodules usually cause clinical symptoms or cosmetic concerns and therefore require treatment. Traditionally the treatment for benign thyroid nodules consists of surgery and levothyroxine medication, however, both have many drawbacks. Minimally invasive surgical alternatives are becoming more attractive for the treatment of thyroid nodules. Beside Radiofrequency ablation (RFA), Microwave ablation (MWA) is a method of thermal ablation to induce thyroid tissue necrosis and has been applied to various benign and malignant tumors with good results.

Objectives: We determine the safety and efficacy of the Microwave Ablation procedure to treat large benign thyroid nodules.

Materials and Methods: We report a series of 40 large benign thyroid nodules patients who underwent Microwave Ablation for treatment at Thoracic Surgery Department Cho Ray hospital from Apr-2018 to Sep-2019.

Results: There were 31 females and 9 males, with a median age of 46 years. The medians with the largest diameter and volume of the nodules were 40 mm and 22 ml. Four (10%) minor complications were observed. The mean volume reduction ratio (VRR) was 75.1, 85.2, and 96.4% after 3, 6, and 12 months. The mean symptom and cosmetic scores dropped from 8.0 and 2.8 (before treatment) to 2.8 and 1.3 (at 12 months), respectively. Thirteen nodules (31%) require two MWA sessions.

Conclusions: MWA is safe, effective, and can be a good option to treat large benign thyroid nodules. More studies with large datasets and long follow-ups are needed to improve its safety and efficacy.

Keywords: Large benign thyroid nodules; Microwave ablation (MWA); Volume reduction ratio; Symptom score; Cosmetic score.