Prospects of laser ablation of benign thyroid nodules. Literature review

Abstract

The article is a review of the literature on the use of laser thermal ablation (LTA) for the destruction of benign nodular formations of the thyroid gland. According to various data, up to 60 % of the treated nodes do not respond to this type of treatment and there is no consensus among researchers about the causes of LTA failures. When performing LTA, different wavelengths and radiation power are used, the number and duration of sessions and the amount of energy delivered to the node differ, all this contributes to a large variability in the response to treatment, makes it difficult to compare data, final assessment of the effectiveness and, to a certain extent, the safety of the method. Regarding the effect on the success of treatment of morphological features, size and position of the node in the thyroid gland, contradictory results are also presented in the literature. The high variability of treatment results makes some authors believe that the effect of laser ablation of thyroid nodes is unpredictable. It should also be noted that most often in studies, a decrease in the size of nodes is estimated, which in itself has questionable clinical significance, and data on the success of eliminating functional autonomy are ambiguous. Thus, despite almost a quarter of a century of using LTA for the treatment of nodular goiter and a large number of published studies, none of the fundamental questions concerning optimal schemes for conducting and improving the effectiveness of procedures, including in patients with functional autonomy and large nodular formations, has received a definitive answer.