Laser-induced thermotherapy of thyroid nodules with ablation of vessels feeding the nodule

Abstract

Objective. To improve the results of treatment in patients with benign nodular pathology of the thyroid gland (TG) by means of perfecting the technique of minimally invasive treatment with a high-intensive laser under the sonographic control. Materials and methods. An original technique of laser-induces thermotherapy (LITT) of the thyroid nodule with the ablation of the vessels, feeding the nodule was developed and introduced. The procedure was used in the treatment of 91 patients with benign nodular pathology of the thyroid gland, 116 patients underwent laser-induced thermotherapy by the standard technique (comparison group). Three months later, US was used to assess and compare the results of treatment in both groups. The results of thermometry were analyzed depending on the initial volume of the TG nodular neoplasm. Results. A decrease in the nodules with the initial volume up to 2 cm3 in both groups was statistically significant and took place practically similarly 78.7 % in the main group and 71.7 % in the comparison group. When exposing the nodules of larger sizes, the efficiency of standard LITT method fell. In the comparison group, patients with the nodular sizes of 68 cm2 had a decrease in the volume only by 25.8 % % (from 6.74 cm3 to 5.0 cm3). When using an original method of thermoablation (TA), a decrease in the nodules of the same size was 69.3 % (from 6.98 cm3 to 2.14 cm3). The difference was statistically significant (p = 0,003) that proves the efficiency of this technique. In the subgroup with the nodules 8 cm3, a nodular volume decrease was 33.3 % (from 11.05 to 7.36 cm3) in the main group and 28.8 % (from 14.07 to 10.02 cm3) in the comparison group. The difference was not statistically significant (p = 279). Conclusions. Laser-induces thermotherapy of the thyroid gland with the ablation of the vessel, feeding the nodule, leads to a statistically significant reduction of the benign colloid nodular neoplasms of any size. The original technique indicated higher efficiency compared with standard LITT in relation to the nodules sized from 6 to 8 cm.