Hu Caihui,Chen Jingyu,Zheng Chenpeng,et al.Clinical outcomes of microwave ablation under ultrasonic guidance for benign thyroid nodules in children[J].Journal of Clinical Pediatric Surgery,,():262-266.[doi:10.3760/cma.j.cn101785-202306027-012]
Click Copy

Clinical outcomes of microwave ablation under ultrasonic guidance for benign thyroid nodules in children

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2024 No.03 Page: 262-266 Column: 论著 Date of publication: 2024-03-01
Author(s):
Hu Caihui1;  Chen Jingyu1;  Zheng Chenpeng2;  Tang Yi1;  Zhao Zhenzhen3;  Kong Xiangru3
1 Department of Ultrasonography, Affiliated Children’s Hospital, Chongqing Medical University, National Clinical Research Center for Children’s Health & Disorders, Ministry of Education’s Key Laboratory of Children’s Development & Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China;
2 Department of Ultrasonography, Municipal Emergency Medical Center, Chongqing 400016, China;
3 Department of Surgical Oncology, Affiliated Children’s Hospital, Chongqing Medical University, Chongqing 400014, China
Keywords:
Benign Thyroid Nodules; Microwave Ablation; Thyroid Hormones; Surgical Procedures; Operative; Child
DOI:
10.3760/cma.j.cn101785-202306027-012
Abstract:
Objective To explore the safety,clinical efficacies and outcomes of ultrasound-guided percutaneous microwave ablation for children with benign thyroid nodules.Methods A retrospective analysis was conducted for the clinical data of 9 children with benign thyroid nodules undergoing ultrasound-guided percutaneous microwave ablation from January 2022 to December 2022.The relevant parameters included general surgical profiles (incision size,total operative duration,ablation duration,intraoperative volume of blood loss & necessity for blood transfusion),pain scores,thyroid function and ultrasound-related parameters.Results In 9/14 nodules,overall operative duration was (45.11±4.85)(23-65) min,ablation time (188.89±50.37)(40-500) sec and intraoperative volume of hemorrhage (0.3±0.03)(0.1-0.4) mL.The postoperative Wong-Baker pain rating scale (FACES) scores were (2-4)/(0-2) points at 12/24 h.Immediate postoperative contrast-enhanced ultrasonography confirmed the ablation rate of all 14 nodules was 100%.The median nodule volume was 0.73(0.14,3.62)cm3 before operation,0.54(0.15,1.49)cm3 at 1 month after opeation,0.03(0.02,0.25)cm3 at 4 months after operation,The nodule volume at 4 months after operation was significantly smaller than that before operation(H=12.174,P=0.018) and 1 month after operation(H=12.036,P=0.028)The serum FT3 was (6.44±1.42)(4.43-8.2) Pmol/L pre-operation,(12.8±3.37)(8.36-18.5) Pmol/L at 12 h post-operation,(7.54±1.56)(5.36-9.53) Pmol/L at Month 1 post-operation.Serum FT3 was significantly higher at 12 h post-operation than pre-operation (F=19.636,P<0.001).No statistically significant differences existed in serum levels of FT4 and TSH at various timepoints (P>0.05).Neither adverse reactions nor postoperative complications occurred.Conclusions Ultrasound-guided percutaneous microwave ablation is ideal benign thyroid nodules in children.It offers such advantages as mini-invasiveness,high safety,satisfactory outcomes,minimal damage to thyroid function and minimal pains.However,the study’s limited sample size necessitates further large-scale trials for validating the findings.

References:

[1] Bauer AJ.Thyroid nodules in children and adolescents[J].Curr Opin Endocrinol Diabetes Obes,2019,26(5):266-274.DOI:10.1097/MED.0000000000000495.
[2] 国家儿童医学中心,国家儿童肿瘤监测中心,中华医学会小儿外科学分会,等.中国儿童甲状腺结节及分化型甲状腺癌专家共识[J].中华实用儿科临床杂志,2020,35(20):1521-1530.DOI:10.3760/cma.j.cn101070-20200804-01291.National Center for Children’s Health,National Children’s Cancer Surveillance Center,Branch of Pediatric Surgery,Chinese Medical Association,et al.Expert Consensus on Thyroid Nodules and Differentiated Thyroid Cancer for Chinese Children[J].Chin J Appl Clin Pediatr,2020,35(20):1521-1530.DOI:10.3760/cma.j.cn101070-20200804-01291.
[3] Bukarica S,Anti? J,Fratri? I,et al.Thyroid surgery in children:a 5-year retrospective study at a single paediatric surgical center and systematic review[J].Children (Basel),2022,9(12):1818.DOI:10.3390/children9121818.
[4] Goldfarb M,Dinauer C.Differences in the management of thyroid nodules in children and adolescents as compared to adults[J].Curr Opin Endocrinol Diabetes Obes,2022,29(5):466-473.DOI:10.1097/MED.0000000000000754.
[5] Ignjatovi? M,Cuk V,Ozegovi? A,et al.Early complications in surgical treatment of thyroid diseases:analysis of 2100 patients[J].Acta Chir Iugosl,2003,50(3):155-175.
[6] Cheng ZG,Liang P.Advances in ultrasound-guided thermal ablation for symptomatic benign thyroid nodules[J].Adv Clin Exp Med,2020,29(9):1123-1129.DOI:10.17219/acem/125433.
[7] Divarc? E,?eltik ü,D?kümcü Z,et al.Management of childhood thyroid nodules:surgical and endocrinological findings in a large group of cases[J].J Clin Res Pediatr Endocrinol,2017,9(3):222-228.DOI:10.4274/jcrpe.4272.
[8] Lee KA,Sharabiani MTA,Tumino D,et al.Differentiated thyroid cancer in children:a UK multicentre review and review of the literature[J].Clin Oncol (R Coll Radiol),2019,31(6):385-390.DOI:10.1016/j.clon.2019.02.005.
[9] Christison-Lagay ER,Baertschiger RM,Dinauer C,et al.Pediatric differentiated thyroid carcinoma:an update from the APSA Cancer Committee[J].J Pediatr Surg,2020,55(11):2273-2283.DOI:10.1016/j.jpedsurg.2020.05.003.
[10] Du JR,Li WH,Quan CH,et al.Long-term outcome of microwave ablation for benign thyroid nodules:over 48-month follow-up study[J].Front Endocrinol (Lausanne),2022,13:941137.DOI:10.3389/fendo.2022.941137.
[11] Li LW,Qiu XG.Safety and efficacy of ultrasound-guided radiofrequency ablation for benign nonfunctional thyroid nodules in children:a retrospective study of 62 patients with over four years of follow-up[J].Thyroid,2022,32(5):525-535.DOI:10.1089/thy.2021.0454.
[12] 石文媛,陈佳佳,张潇,等.超声引导经皮微波消融治疗儿童难治性甲状腺功能亢进症1例[J].中华超声影像学杂志,2022,31(8):730-732.DOI:10.3760/cma.j.cn131148-20220530-00390.Shi WY,Chen JJ,Zhang X,et al.Ultrasound-guided percutaneous microwave ablation for refractory hyperthyroidism in children:one case report[J].Chin J Ultrasonogr,2022,31(8):730-732.DOI:10.3760/cma.j.cn131148-20220530-00390.
[13] 李宇靖,杨小敏,徐志坚.甲状腺结节消融术研究进展[J].中国中西医结合耳鼻咽喉科杂志,2021,29(4):318-320,307.DOI:10.16542/j.cnki.issn.1007-4856.2021.04.021.Li YJ,Yang XM,Xu ZJ.Research advances of thyroid nodule ablation[J].Chin J Otorhinolaryngol Integr Med,2021,29(4):318-320,307.DOI:10.16542/j.cnki.issn.1007-4856.2021.04.021.
[14] 孙永强,杨雯雯,郑帅,等.微波消融治疗甲状腺良性结节短期、中期临床效果观察及影响因素分析[J].中国临床医生杂志,2019,47(9):1064-1067.DOI:10.3969/j.issn.2095-8552.2019.09.019.Sun YQ,Yang WW,Zheng S,et al.Observation of short/medium-term clinical effects and analysis of influencing factors of microwave ablation for benign thyroid nodules[J].Chin J Clin,2019,47(9):1064-1067.DOI:10.3969/j.issn.2095-8552.2019.09.019.
[15] 任云,王圣应,黄广岩,等.微波消融治疗甲状腺良性结节的疗效及预后影响因素分析[J].宁夏医科大学学报,2021,43(3):277-281.DOI:10.16050/j.cnki.issn1674-6309.2021.03.014.Ren Y,Wang SY,Huang GY,et al.Outcomes and prognostic factors of microwave ablation for benign thyroid nodule[J].J Ningxia Med Univ,2021,43(3):277-281.DOI:10.16050/j.cnki.issn1674-6309.2021.03.014.
[16] 李柯伶,马亦龙.甲状腺良性结节微波消融和手术切除临床疗效和安全性对比分析[J].中国介入影像与治疗学,2017,14(8):464-467.DOI:10.13929/j.1672-8475.201703035.Li KL,Ma YL.Comparative study of clinical efficacy and safety of microwave ablation and surgical resection of benign thyroid nodules[J].Chin J Interv Imaging Ther,2017,14(8):464-467.DOI:10.13929/j.1672-8475.201703035.

Memo

收稿日期:2023-6-15。
通讯作者:孔祥如,Email:Kongru873@163.com

Last Update: 1900-01-01