To evaluate the efficacy of ethanol ablation (EA) in the treatment of cystic thyroid nodules using low dose ethanol regardless of initial volume of the nodule or aspirates. Methods: 61 nodules in 60 patients were treated with EA from October 2013 to January 2020. In each patient, EA was performed only once using less than 5mL ethanol (99.5%) instilled and removed completely after a few minutes of retention. Nodule volume, symptom score, cosmetic score and complications were evaluated before and after treatment. Therapeutic success rate (TSR) and volume reduction rate (VRR) according to nodule volume and properties of the aspirates were evaluated. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (≥50%) with improvement of nodule-related symptoms. Results: 61 nodules were 38 of pure cysts and 23 of predominantly cystic nodules. The initial nodule volume was 21.9 ± 15.2mL (range 4.4-77.2 mL). TSR was 88.5% (100% in pure cysts and 69.6% in predominantly cystic nodules, p<0.001). TSR of pure cysts was 100% regardless of nodule volume and properties of aspirates. In predominantly cystic nodules, TSR and VRR were gradually decreased as volume increases. One patient experienced arrhythmia during the procedure, but completely recovered without sequelae. Conclusion: Single-session EA using low dose ethanol might be effective in the treatment of symptomatic cystic thyroid nodules regardless of initial volume and properties of aspirates, especially in pure cysts.
Purpose: This study aimed to evaluate the efficacy of additional radiofrequency ablation (RFA) treatment for benign thyroid nodules.Methods: Electronic medical records at a single institution from September 2008 to August 2016 were searched, and consecutive patients treated with RFA due to benign thyroid nodules with cosmetic or symptomatic problems were enrolled. All patients were followed up for at least 30 months. The nodules were divided into three groups: group 1 included nodules that met the criteria for additional treatment and underwent additional treatment, group 2 included nodules that met the criteria but did not undergo additional treatment, and group 3 included nodules that did not meet the criteria. The ablation results were compared among the three groups in terms of the initial ablation ratio (IAR) and volume reduction ratio (VRR).Results: Ninety nodules from 88 patients were included in the study. At the last follow-up, group 1 showed a significantly smaller nodule volume and larger VRR (2.5 mL and 84.6%, respectively) than group 2 (8.1 mL and 39.8%, respectively, P<0.001), but did not present a significant difference from group 3 (0.9 mL, P=0.347, and 92.8%, P=0.238). The IAR was significantly higher in group 3 (94.5%) than in the other two groups (group 1, 81.1%; group 2, 82.8%; P<0.001).Conclusion: Multiple treatment sessions achieve greater VRR. Therefore, additional treatment could be considered for patients who meet the corresponding criteria.
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