Efficiency and safety of sclerotherapy for recurrent nodular goiter

Abstract

At present, patients with recurrent nodular goiter account for a significant portion of patients operated on for nodular goiter. At the same time, the comorbid background characteristic of this age group and the technical difficulties of the intervention on cicatricial tissues of the neck cause a high risk of complications of the operation, 3–7 times higher than with primary thyroid interventions. The aim of the study was to evaluate the effectiveness and safety of treatment of recurrent nodular goiter using an alternative minimally invasive method — sclerotherapy. The study included 30 patients previously operated on for nodular goiter. All had 4 courses of sclerotherapy, each included 5 sessions with a frequency of 1 session per week, followed by a follow-up period of 3 months. Polydocanol was used as a sclerosant. The analysis showed that sclerotherapy for recurrent nodular goiter allows all patients to reduce recurrent nodular formations, and in almost a third of cases, complete reduction of the nodes. On average, the decrease in the volume of thyroid residues was 9.6 ± 1.5 ml, and the size of nodular formations decreased by 17.2 ± 1.3 mm (3.7 times — from 23.6 ± 1.4 mm to 6.4 ± 0.7 mm, P <0.001). Nodes more than 3 cm, initially 19 %, ceased to be detected after the third course of sclerotherapy. In all cases, managed to eliminate hormonal imbalances in patients who initially had functional autonomy, as well as signs of compression of the neck organs. At the same time, sclerotherapy of nodules of the thyroid gland using polydocanol as a sclerosant is a safe minimally invasive treatment method, is not accompanied by severe pain and the risk of hypoparathyroidism and laryngeal paresis.