Evaluation of percutaneous ethanol injections in benign thyroid nodules

Perez, Camila Luhm Silva; Fighera, Tayane Muniz; Miasaki, Fabíola Yukiko; Mesa, Cléo Otaviano; Filho, Gilberto Da Paz; Graf, Hans; Carvalho, Gisah Amaral de

doi:10.1590/0004-2730000003444

Cited by 16 publications

(15 citation statements)

References 24 publications

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“…The changes caused by ethanol in thyroid tissue, such as necrosis and fi brosis were considered possible complicating if there is need for further surgery on the gland (22). How ever, with the IPE technique guided by US, only the nodule suffers action of ethanol, sparing the surround ing tissue, also explaining the low rate of early and late complications (23). Other authors also evaluated macroscopically and microscopically glandular ethanol changes, which claim that the therapy does not affect the extranodular tissue (9).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

Ferreira

Piaia²,

Cadore³

2016

Arch. Endocrinol. Metab.

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Objective: To evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in reducing the volume of cystic and mixed thyroid nodules. Materials and methods: A total of 36 patients with nodules treated with PEI and 13 individuals who declined PEI and were followed clinically or received other non surgical treatment (control group). Assessments were performed at baseline (immediately before treatment in the PEI group or evaluation of the nodule on ultrasonography in the control group) at short-term (on average 30 days after the last injection in the PEI group), and long-term (on average 14 months after baseline in the PEI group or 26 months after baseline in the control group). Results: In the PEI group, the mean baseline volume of 10.4 ± 9.8 cm³ reduced at short-term followup to 2.9 ± 3.1 cm³ (67.7 ± 19.9%, p < 0.001) and at long-term follow-up to 2.0 ± 2.5 cm³ (78.2 ± 19.5%, p < 0.01 versus baseline and p = 0.009 versus short-term follow-up). Both types of nodules showed similar degrees of reduction. In the control group, mean volume was 5.8 ± 3.4 cm³ at baseline and 6.2 ± 3.0 cm³ at long-term follow-up (p = 0.507). Compared with the control group, the PEI group showed larger reduction (p < 0.001). Conclusions: PEI is effective in reducing the volume of cystic and mixed benign thyroid nodules, with sustained long-term efficacy and better outcome when compared with conservative therapies. Treatment with PEI is a safe alternative, with minimal, transient and selflimited adverse events. Arch Endocrinol Metab. 2016;60(3):211-6

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Section: Discussionmentioning

confidence: 99%

Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

Ferreira

Piaia²,

Cadore³

2016

Arch. Endocrinol. Metab.

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“…Ethanol sclerotherapy is also associated with some complications. Mild transient pain or a burning sensation at the site of injection is the most commonly seen following ethanol sclerotherapy and is a result of leakage of ethanol into the subcutaneous tissue [4, 6]. Other uncommon complications include hematoma, dyspnea, and vocal cord paralysis [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Ultrasound-Guided Percutaneous Polidocanol Sclerotherapy in Benign Cystic Thyroid Nodules: Preliminary Results

Gong

Zhou

Wang

et al. 2017

International Journal of Endocrinology

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Objective To evaluate the efficacy and safety of percutaneous polidocanol injection (PPI) in treating cystic thyroid nodules. Materials and Methods A total of 158 cystic or predominantly cystic thyroid nodules (>80% cystic component) in 143 patients were evaluated. 114 patients with compressive symptoms or aesthetic complaints were offered PPI. 44 individuals without compressive symptoms and aesthetic complaints who were only followed up clinically were used as the control group. The efficacy and safety of PPI were evaluated for 1 month, 3 months, 6 months, 9 months, and 12 months of follow-up. Results In the PPI group, the mean baseline volume of 15.6 ± 18.9 cm3 reduced at the 1-month follow-up to 5.1 ± 5.6 cm3 (p < 0.001) and 0.6 ± 0.9 (p < 0.001), and nodules shrunk according to the time after PPI (p < 0.001). A complete response (if ≥70% decrease) to PPI at the 12-month follow-up occurred in 100% of the cystic or predominant cystic nodules. None of the nodules recurred at the 12-month follow-up after PPI. The side effects were mild. Twenty patients (17.5%) developed mild localized pain, and fourteen cases (12.3%) experienced mild or moderate fever after PPI. Conclusions PPI is a safe and effective alternative to treat benign cystic or predominant cystic thyroid nodules.

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“…Thyroid nodules (TNs) are common entities, often detected in clinical practice, with a largely variable prevalence, depending on the diagnostic method ( 1 , 2 ). Epidemiological studies have shown that 4–7% of women and 1% of men living in iodine-sufficient regions present palpable TNs ( 3 , 4 ), whereas ultrasound (US) detects nodules in up to 76% of the adult population, with a greater incidence in women and elderly people ( 5 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules

et al. 2016

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ContextUltrasound (US)-guided percutaneous ethanol injection (PEI) has been proposed for treatment of benign thyroid nodules (TNs). However, there is no consensus for the optimal amount of ethanol injection, number of applications, and time to re-evaluation in order to achieve maximum volume reduction with minimum adverse effects.ObjectiveThe purpose of the present study was to analyze the effectiveness of an US-guided PEI protocol to treat solid and mixed TNs based on a new target outcome.Patients and methodsWe performed a prospective study evaluating the results of PEI in 52 patients with benign solid and mixed TNs. The ethanol dose was fixed in 30% of the nodular volume per session. Patients returned 1 month after each session for US re-evaluation. Therapeutic success was defined as volume reduction of at least 30% associated with disappearance of clinical symptoms and a complete esthetic satisfaction reported by the patient.ResultsWe performed a mean of 2.8 ± 1.9 PEI sessions, with an average total volume of ethanol injected of 9.1 ± 10.3 ml, and a follow-up time of 10.0 ± 8.7 months. There was a reduction of at least 50% of the initial nodular volume in 33 patients (63.5%). In 11 patients (21.2%), the reduction did not reach 50% (mean reduction of 31 ± 11%), but 6 of them reported esthetically satisfactory results and treatment was stopped. Our therapeutic success rate considering the patients with esthetic improvement was 75%. There were no severe complications.ConclusionOur protocol is effective and safe to treat solid and mixed benign TNs based on our established outcome.

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Evaluation of percutaneous ethanol injections in benign thyroid nodules

Cited by 16 publications

References 24 publications

Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

Efficacy and Safety of Ultrasound-Guided Percutaneous Polidocanol Sclerotherapy in Benign Cystic Thyroid Nodules: Preliminary Results

Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules

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