射频消融作为甲状腺叶切除术后甲状腺结节的安全有效治疗方法
Radiofrequency Ablation as a Safe and Effective Treatment for Thyroid Nodules After Lobectomy.
文献信息
| PMID | 42736038 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yaser Bashumeel |
| 作者单位 | Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 既往接受过单侧甲状腺叶切除术的患者，对侧残留叶可能出现新的有症状结节或原有结节增大而需要治疗。传统处理常导致完成性甲状腺切除术，但射频消融（RFA）提供了一种微创的替代手术切除的方法。我们评估了RFA治疗这些病例的安全性和有效性。
方法： 这项回顾性研究纳入47例有甲状腺叶切除术史并因对侧叶甲状腺结节接受RFA的患者。8例有甲状腺乳头状癌（PTC）病史，25例为高功能结节，14例为有症状的甲状腺结节。主要结局为3个月、6个月和末次随访时的体积缩小率（VRR）。次要结局为RFA后并发症和甲状腺功能的维持。
结果： 末次随访时中位VRR为81.0%[IQR：58%-89%]。6.4%的患者达到完全消失，而随访期间2.1%的病例观察到进展。RFA后并发症极少，3例患者出现暂时性声带麻痹，2例患者报告术后不适/疼痛。未观察到其他并发症。没有患者出现基线甲状腺功能改变，也没有新发甲状腺功能减退或甲状腺功能亢进病例。
结论： 对于甲状腺叶切除术后患者的残留甲状腺结节，RFA是完成性甲状腺切除术的安全有效替代方案。在有经验的操作者手中，RFA可实现具有临床意义的体积缩小，同时保持较低的并发症发生率。
英文摘要
BACKGROUND: A new symptomatic nodule may develop or a preexisting nodule may grow to warrant treatment in the remaining lobe of patients who previously had a unilateral thyroid lobectomy. Conventional management often results in completion thyroidectomy, but radiofrequency ablation (RFA) offers a minimally invasive alternative to surgical resection. We evaluated the safety and efficacy of RFA in treating these cases.
METHODS: This retrospective study included 47 patients with a history of thyroid lobectomy who underwent RFA for thyroid nodules in the contralateral lobe. Eight patients had a history of papillary thyroid carcinoma (PTC), 25 had hyperfunctioning nodules, and 14 had symptomatic thyroid nodules. Primary outcomes were the volume reduction ratio (VRR) at 3 months, 6 months, and final follow-up. Secondary outcomes were post-RFA complications and maintenance of thyroid function.
RESULTS: Median VRR at final follow-up was 81.0% [IQR: 58%-89%]. Complete disappearance was achieved in 6.4% of patients, while progression was observed in 2.1% of cases during follow-up. Post-RFA complications were minimal, with three patients experiencing temporary vocal cord paresis and two patients reporting post-procedure discomfort/pain. No other complications were observed. No patient experienced a change in baseline thyroid function, and no new cases of hypothyroidism or hyperthyroidism occurred.
CONCLUSION: RFA is a safe and effective alternative to completion thyroidectomy for remaining thyroid nodules in post-lobectomy patients. RFA allows clinically meaningful volume reduction while maintaining a low complication rate in the hands of an experienced operator.