The efficacy and safety of microwave ablation versus conventional open surgery for the treatment of papillary thyroid microcarcinoma: a systematic review and meta-analysis

Abstract

Background: Microwave ablation (MWA) technology has been applied to the treatment of papillary thyroid microcarcinoma (PTMC); however, its use as an alternative to conventional open surgery (OS) remains controversial, because it belongs to non-tumor radical treatment. Our article sought to compare the efficacy and safety of MWA and OS in the treatment of PTMC.Methods: We searched seven databases for studies evaluating the treatment of patients with PTMC using MWA as intervention group and OS as control group, the main outcome contained intra-operative, postoperative and follow-up outcomes. Review Manager 5.4 was used to estimate the effects of the results of the included articles and Cochrane Risk of Bias 2.0 was used to assess the risk of bias. The data were pooled to calculate the mean differences (MD) with 95% confidence intervals (CIs) for the continuous data and the odds ratio (OR) with 95% CIs for the dichotomous data.Results: A total of 13 studies, comprising 1,088 and 1,081 patients in the MWA and OS groups, respectively, were identified that compared the results of MWA to OS in the treatment of PTMC. All of the articles were at low risk of bias. There were no differences in terms of the recurrence rate (OR =0.80, 95% CI: 0.37 to 1.77; P=0.59) or lymph node metastasis (OR =0.71, 95% CI: 0.26 to 1.95; P=0.51) between the 2 groups. However, compared to the OS group, the MWA group had a shorter operation time (MD =-44.

Comparison of the effectiveness of ultrasound-guided radiofrequency ablation and conventional open thyroidectomy in the treatment of benign thyroid nodules

“…In contrast, OT requires large incision for the removal of thyroid lobes, parathyroid glands, etc., and causes significant trauma with greater amount of intraoperative bleeding, prolonged postoperative recovery time, and increased risk of complications. 16,17 Fung et al 18 conducted long-term follow-up on more than one thousand patients with thyroid nodules who received conventional open thyroidectomy, and found that about 28% of the patients had thyroid function damage after surgery, and required thyroxine, mainly due to the damage of parathyroid gland during surgery. 19 In this study, patients who underwent USguided RFA did not show significant changes in postoperative thyroid function, while patients who received conventional open thyroidectomy showed a significant decrease in thyroid function.…”