Clinical Thyroidology / Research Article

Ma Y.a· Wu T.a· Yao Z.b· Zheng B.a· Tan L.a· Tong G.a· Lian Y.a· Baek J.H.c· Ren J.a

Author affiliations

aDepartment of Medical Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, China
bGeneral Surgery Department, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou City, China
cDepartment of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Article / Publication Details

First-Page Preview

Received: March 17, 2021
Accepted: June 30, 2021
Published online: October 15, 2021

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 2

ISSN: 2235-0640 (Print)
eISSN: 2235-0802 (Online)

For additional information: https://www.karger.com/ETJ

Abstract

Introduction: Small-volume hydrodissection liquid dissipates rapidly and confers only short-term protection during radiofrequency ablation (RFA) of benign thyroid nodules. The aim of this study was to establish a safe method for continuous, large-volume hydrodissection. Methods: A long needle was inserted and positioned outside the thyroid capsule; 5% glucose was injected to maintain a 3- to 5-mm continuous safety buffer. From October 2015 to July 2020, 166 patients underwent hydrodissection with different volumes, and ablation efficacy and complications associated with different liquid volumes (≤40 mL vs. >40 mL) were compared at 1-month postprocedure. Moreover, 20 mL liquid (equivalent to 250 mL in the human body) was injected around the thyroid of a rhesus monkey, after which CT scans were used to visualize the liquid’s fate and verify its safety. Results: The 51 patients with 10–40 mL injections and 116 patients with larger injections (45–450 mL) showed similar complete ablation rates (88.46% vs. 90.44%, p = 0.582), comparable 6-month VRR (82.79% vs. 76.62%, p = 0.079), and complication incidences, although the latter group had larger nodules (9.11 mL vs. 13.79 mL, p = 0.003), more energy delivered (3.44 kcal vs. 6.04 kcal, p < 0.001), and longer operation times (51.37 min vs. 69.2 min, p < 0.001). In the animal experiment, the 20 mL of liquid diffused quickly (within 10 min) from the vicinity of the thyroid to the mediastinum and retropharyngeal space. It was observed in the kidneys at 10 min and disappeared from the neck and chest space by 24 h. Conclusions: Continuous, large-volume hydrodissection can protect the delicate structures around the thyroid throughout the RFA procedure and might be beneficial in large thyroid nodule ablation.

© 2021 European Thyroid Association. Published by S. Karger AG, Basel

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First-Page Preview

Received: March 17, 2021
Accepted: June 30, 2021
Published online: October 15, 2021

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 2

ISSN: 2235-0640 (Print)
eISSN: 2235-0802 (Online)

For additional information: https://www.karger.com/ETJ

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