Hydrodissection and programmed stop sedation in 100 % of benign thyroid nodules treated with radiofrequency ablation.

Autor: Souza KP; Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, 05652-000 Brazil. Electronic address: katiapinheirods@gmail.com., Rahal A Jr; Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, 05652-000 Brazil; Department of Radiology, Hospital Israelita Albert Einstein. São Paulo, 05652-000 Brazil. Electronic address: antoniorahal@gmail.com., Volpi EM; Head and Neck Surgery, Amato - Instituto de Medicina Avançada. São Paulo, 01431-001 Brazil; Hospital Alemão Oswaldo Cruz, São Paulo, 01323-020 Brazil. Electronic address: eriveltovolpi@gmail.com., Falsarella PM; Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, 05652-000 Brazil. Electronic address: primina@gmail.com., Hidal JT; Department of Endocrinology, Hospital Israelita Albert Einstein. São Paulo, 05652-000 Brazil. Electronic address: hidal@einstein.br., Andreoni DM; Department of Endocrinology, Hospital Israelita Albert Einstein. São Paulo, 05652-000 Brazil. Electronic address: danielle.macellaro@gmail.com., Francisco-Neto MJ; Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, 05652-000 Brazil. Electronic address: miguel.jneto@einstein.br., Queiroz MRG; Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, 05652-000 Brazil; Department of Radiology, Hospital Israelita Albert Einstein. São Paulo, 05652-000 Brazil. Electronic address: marcos.queiroz@einstein.br., Garcia RG; Department of Radiology, Hospital Israelita Albert Einstein. São Paulo, 05652-000 Brazil. Electronic address: rodrigo.gobbo@einstein.br.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2020 Dec; Vol. 133, pp. 109354. Date of Electronic Publication: 2020 Oct 16.
DOI: 10.1016/j.ejrad.2020.109354
Abstrakt: Purpose: To describe our group experience in treatment of benign symptomatic thyroid nodules using radiofrequency ablation technique always associated to routine pre-procedure hydrodissection and under sedation with programmed stop.
Methods: Dual-center, retrospective study conducted between April 2018 and January 2020. A total of 52 symptomatic benign thyroid nodules were treated in 34 patients with ultrasound-guided percutaneous radiofrequency ablation. The technique of choice was moving-shot technique and 100 % patients underwent pre-procedural hydrodissection with 5% glucose solution, plus conscious sedation with programmed stop during procedure.
Results: Most nodules were solid or almost completely solid (n = 45, 88.3 % of nodules), followed by cystic composition (n = 4, 7.8 %) and mixed (n = 2, 3.9 %). As for location, most were on the right lobe (n = 29, 56.9 %), followed by the left lobe (n = 17, 33.3 %) and isthmus (n = 5, 9.8 %). The average volume of nodules before ablation was 18.2 ± 20.5 mL. Volumetric reduction rates at one, three, six and twelve months after ablation were 46.6 %, 64.5 %, 76.1 % and 88.8 %, respectively. No complications strictly related to procedure were reported. No more than 5 min were added to total time of ablative treatment considering routine hydrodissection and stop programmed sedation.
Conclusions: Minimally invasive therapies applied to thyroid allow the preservation of healthy thyroid parenchyma and provide a very effective volumetric reduction of symptomatic benign thyroid nodules. Hydrodissection with 5 % glucose solution, conscious sedation and patient stimulation with programmed stop during procedure may provide greater safety to procedure, and, in our experience, could be done routinely in all patients.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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