Minimally invasive techniques for the management of benign thyroid nodules: Efficacy and impact on quality of life of percutaneous ethanol injection. Results from a high-resolution thyroid nodule unit

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2024-11-01 DOI:10.1016/j.endien.2024.11.003

Javier Bodoque Cubas , José Fernández Sáez , Sergio Martínez Hervás , José Vicente Gil Boix , Juan José Salazar González , Raquel María Pallarés Gassulla , Sara Martínez Pérez , Marcel la Miret Llauradó , Iñaki Argüelles Jiménez , Santiago Tofé Povedano

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引用次数: 0

Abstract

Background and objective

The high incidence of thyroid nodular disease has raised concerns on the therapeutic management of benign thyroid nodules. The development of minimally invasive techniques is an alternative to surgery and has a low rate of complications. Our objective was to evaluate the safety and efficacy profile of percutaneous ethanol injections (PEI) with ethanol aspiration of symptomatic cystic and predominantly cystic thyroid nodules (cystic component > 50%) treated in the thyroid nodule high-resolution unit (TNHRU) of Hospital de Tortosa Verge de la Cinta Hospital, Tarragona, Spain.

Patients and methods

The present work is a prospective, observational and descriptive study of 32 patients (87.5% women, mean age of 43; SD, 12) evaluated at the TNHRU from August 2022 through December 2023. Demographic data such as age, sex, previous thyroid function, diagnostic method, initial nodular volume, nodular composition and nodular location were analyzed. Using ultrasounds, measurements of diameters and thyroid nodule volume were taken. We aspirated a total of 50% of the cystic content and injected between 2 mL and 5 mL of 99% ethanol (depending on cystic volume). After letting the ethanol act inside the nodule for 5 to 10 minutes, all the cystic content and the injected ethanol were aspirated. We performed an ultrasound follow-up at 1, 3 and 6 months, calculating the total volume and the volume reduction rate (VRR). The impact on health-related quality of life (HRQoL) was assessed using the ThyPRO-39es questionnaire, which was administered before and after the PEI treatment at the 6-month follow-up.

Results

The median volume reduction at the end of the 6-month follow-up was 0.23 mL (0.00–0.67), and the VRR, 98.57% (94.80–100.00). The difference between the initial volume and the mean volume at the 1-, 3-, and 6-month follow-ups was statistically significant, as was the VRR between the 1-month and the 3- and 6-month follow-ups. Six patients (18.80%) required 2 PEIs and only 2 patients (6.3%) required 3 PEIs. The overall quality of life, which was scored from 0 (good) to 4 (poor), significantly improved from 1.28; SD, 0.81 up to 0.19; SD, 0.40 (p < 0.001).

Conclusions

PEI is an effective alternative to treat cystic thyroid nodules resulting in an improved patients' HRQoL. It can be performed outpatiently with a low rate of complications, thus making it suitable for inclusion in the service portfolio of a HRTNU.

查看原文本刊更多论文

治疗甲状腺良性结节的微创技术：经皮乙醇注射的疗效及其对生活质量的影响。高分辨率甲状腺结节检查结果。

背景和目的：甲状腺结节疾病的高发病率引起了人们对甲状腺良性结节治疗方法的关注。微创技术的发展可替代手术，且并发症发生率低。我们的目的是评估经皮乙醇注射（PEI）和乙醇抽吸治疗无症状囊性和主要囊性甲状腺结节（囊性成分大于 50%）的安全性和有效性：本研究是一项前瞻性、观察性和描述性研究，研究对象是2022年8月至2023年12月期间在TNHRU接受评估的32名患者（87.5%为女性，平均年龄43岁；SD为12）。研究分析了年龄、性别、既往甲状腺功能、诊断方法、初始结节体积、结节组成和结节位置等人口统计学数据。我们通过超声波测量了甲状腺结节的直径和体积。我们总共抽吸了50%的囊肿内容物，然后注入2毫升到5毫升的99%乙醇（取决于囊肿体积）。让乙醇在结节内作用 5 到 10 分钟后，吸出所有囊内容物和注入的乙醇。我们在 1 个月、3 个月和 6 个月时进行超声随访，计算总体积和体积缩小率（VRR）。我们使用 ThyPRO-39es 问卷评估了对健康相关生活质量（HRQoL）的影响：6 个月随访结束时，体积缩小的中位数为 0.23 mL（0.00-0.67），VRR 为 98.57%（94.80-100.00）。初始容量与 1 个月、3 个月和 6 个月随访时的平均容量之间的差异具有统计学意义，1 个月、3 个月和 6 个月随访时的 VRR 也具有统计学意义。有 6 名患者（18.80%）需要 2 次 PEI，只有 2 名患者（6.3%）需要 3 次 PEI。总体生活质量评分从 0（好）到 4（差），从 1.28；SD，0.81 到 0.19；SD，0.40（P 结论：PEI 是一种有效的替代治疗方法：PEI是治疗甲状腺囊性结节的有效替代方法，可改善患者的HRQoL。它可以在门诊进行，并发症发生率低，因此适合纳入甲状腺肿大治疗网络的服务组合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.