Affiliation:
1. Federal State Budgetary Educational Institution of Higher Education “Yaroslavl State Medical University” of the Ministry of Health of the Russian Federation
2. Clinical Hospital Russian Railways-Medicine of Yaroslavl
Abstract
Relevance. Minimally invasive interventions under ultrasound control are a promising method for treating thyroid nodules with proven clinical effects. Indications for the use of minimally invasive methods are constantly changing and being supplemented. It is of practical interest to expand the indications for interstitial laser photocoagulation of thyroid nodes as experience accumulates. The purpose of the study: to study the changes in indications for performing interstitial laser photocoagulation of thyroid nodes over 15 years.Materials and methods. Based on the experience of treating 876 patients with colloidal goiter using interstitial laser photocoagulation, the dynamics of indications for this technique were studied. The treatment data were analyzed in two-time groups: group 1 — the initial stage of the introduction of the technique, and group 2 — the stage of widespread use of the technique. With the accumulation of experience, the adjustment of photocoagulation and ultrasound modes was carried out. The control of the treatment was evaluated in dynamics by reducing the volume of nodes.Results and conclusions. During the study, it was found that in both groups of patients, it was possible to achieve regression and decrease in the size of the nodes, depending on the pathology and size of the nodes. This made it possible to expand the indications at the expense of patients with large nodes (more than 30 mm in diameter). With recurrent nodular goiter, good results were also obtained. It has been established that interstitial laser photocoagulation is a safe, predictable method of treatment with the possibility of selecting individual regimens, well tolerated by patients. Indications for the use of the method are wide and are set individually based on the predicted risk/effectiveness ratio. The method does not negatively affect the quality of life of patients. When selecting patients, the opinion of both the doctor and patient should be taken into account.
Reference9 articles.
1. Saltykova VG, Aleksandrov YuK, Patrunov YuN. Selection of patients for minimally invasive interventions on thyroid nodes. Tauride medico-biological Bulletin. 2020;(2):187– 94. (In Russ.). doi: 10.37279/2070-8092-2020-232-187-194
2. Romashchenko PN, Maistrenko NA, Krivolapov DS, etc. Modern diagnostic and minimally invasive technologies in thyroid surgery. Bulletin of the Russian Military Medical Academy. 2019;(S1):101–5. (In Russ.)
3. Privalov VA, Kozel AI, Revel-Muroz JA and others. A method of treating nodular forms of thyroid diseases. Patent for the invention RU 2143933 C1, 10.01.2000. Application No. 98104998/14 dated 03/25/1998. (In Russ.).
4. Lu Zhang, Wei Zhou, Jian Qiao Zhou, Qian Shi, Teresa Rago, Giovanni Gambelunghe, Da Zhong Zou, Jun Gu, Man Lu, Fen Chen, Jie Ren, Wen Cheng, Ping Zhou, Stefano Spiezia, Enrico Papini & Wei Wei Zhan. 2022 Expert consensus on the use of laser ablation for papillary thyroid microcarcinoma. International Journal of Hyperthermia. 2022;39:1, 1254–63. doi: 10.1080/02656736.2022.2122596
5. Petrov VG, Sozonov AI, Baksheev EG et. al. Laser-induced thermotherapy of thyroid nodules with ablation of vessels feeding the node. Methodical manual for endocrinologists, surgeons, ultrasound specialists. — Tyumen: RIC «Ivex», 2022. — 84 p. (In Russ.).