Ultrasound guided microwave ablation of thyroid nodular goiter and cystadenoma: A single center, large cohort study

US-Guided Hydrodissection and a Low-Cost Indigenous Retractor Facilitate Endoscopic Thyroid Surgery

Hydrodissection of plane between thyroid and strap muscles and retraction of strap muscles using a low-cost indigenously made retractor are effective in overcoming technical difficulties in transoral endoscopic thyroid surgery. Laryngoscope, 134:993-994, 2024.

Metabolic Disease and Risk of Thyroid Disease: Evidence from the National Nurse Health Cohort in China

BACKGROUND

Previous studies have shown that metabolic diseases are risk factors for thyroid disease; most studies are cross-sectional design. We aimed to evaluate the causal relationship between thyroid and metabolic diseases in a cohort of Chinese nurses.

METHODS

We conducted an ambispective cohort study of the National Nurses' Health Study. Thyroid disease data based on ultrasonography from 2017 to 2021 were collected. We described thyroid disease incidence and the risk factors associated with a cluster of metabolic factors. We used the Mann‒Whitney U test, repeated-measures ANOVA and multivariable Cox proportional hazard regression to analyze the data.

RESULTS

A total of 1529 female nurses without thyroid disease were enrolled in 2017, of which, complete data were available for 1269 nurses. In 2018-2020, thyroid nodule incidence ranged from 32.8%-46.3%, thyroiditis incidence was 13.4%-14.3%, and goiter incidence was 4.1%-29.1%, thyroid adenoma and thyroid tumors incidence were 0.1%-0.5% and 1%-1.5%. We also found that NAFLAD was an independent risk factor for thyroid adenoma (p = .003). The age at diagnosis was an independent risk factor for goiter (p <. 001) and thyroid nodules (p < .001). Fasting blood glucose was an independent risk factor for thyroid tumors (p = .004). The age at diagnosis (p = .003), Body Mass Index (p = .006) and menopause (p = .031) were risk factors for thyroiditis.

CONCLUSION

Thyroid disease incidence among nurses is increasing. Age at diagnosis, BMI, fasting blood glucose, and nonalcoholic fatty liver disease are independent risk factors for different types of thyroid disease. This study provides evidence for future studies to further explore the pathogenesis and prevention of thyroid diseases.

Analysis of risk factors for intra-cystic hemorrhage in microwave ablation of partially cystic thyroid nodules

Objective

The aim of this study is to identify risk factors of intra-cystic hemorrhage in microwave ablation of mixed solid and cystic microwave ablation s, and to design a preoperative nomogram to predict the risk value of intraoperative bleeding with the goal of individualizing the surgical approach toward different types of cystic and solid thyroid nodules.

Methods

A total of 241 patients with cystic-solid thyroid nodules who underwent ultrasound-guided percutaneous microwave ablation were retrospectively divided into a bleeding group and a non-bleeding group to compare the diameter, cystic proportion, cystic fluid nature, color Doppler flow imaging, Contrast-enhanced ultrasound (CEUS) findings, and operative methods. Based on univariate and multivariate analysis, the important risk factors of nodular intracapsular hemorrhage in the ablation procedure were projected to a nomogram for predicting the possibility of intraoperative hemorrhage in the thyroid cystic solid nodules.

Results

Intra-cystic hemorrhage was developed in 37 cases during the ablation of mixed thyroid nodules with a total incidence of 15% (37/241). Significant differences were found statistically between the two groups on the diameter of the lesions, CEUS findings, the cystic fluid ratio, and operative methods (P = 0.000, P = 0.001, P = 0.024, P = 0.002). The possibility of intraoperative nodular intracapsular hemorrhage was predicted by the model based on the risk factors with the accuracy of 81% and prediction consistency index (C-index) of 0.78.

Conclusion

A new and efficient prediction model was developed based on the identified risk factors for intracapsular hemorrhage during microwave ablation of mixed thyroid nodules, which will aid in the development of targeted surgical planning for different types of cystic thyroid nodules, thus reducing the risk of hemorrhage during ablation.

Analysis of the risk factors of negative emotions in patients undergoing microwave ablation of thyroid nodules during the perioperative period and its impact on prognosis: a prospective cohort study

Background

Thyroid nodule (TN) is one or more abnormal lump structures in the thyroid gland parenchyma caused by genetic, environmental, and other factors. It is the most common thyroid disease in clinics. Microwave ablation (MWA) can significantly reduce the nodule volume and effectively reduce the symptoms caused by nodules. However, the patient's negative emotions during the perioperative period may affect the postoperative recovery. This study explored the risk factors of negative emotions in patients during the perioperative period and its impact on patient prognosis. This data provides a basis for clinical psychological interventions before MWA, so as to improve the quality of life of patients with TN.

Methods

A total of 238 patients who were hospitalized for TNs in The First Affiliated Hospital of Soochow University from January 2017 to January 2022, and who received MWA therapy were enrolled in this study. The patients were evaluated with a general situation questionnaire, a Self-rating Anxiety Scale (SAS), and a Self-rating Depression Scale (SDS). The TN volume was followed up to evaluate the prognosis of patients. Binary logistic regression was used to analyze the risk factors of perioperative negative emotions and the impact of negative emotions on the prognosis.

Results

The results of binary logistic regression analysis showed that education, income, hypertension, hyperglycemia, and solid nodule volume were independent influencing factors of anxiety (P<0.05). Age, income, hypertension, hyperglycemia, and solid nodule volume were independent influencing factors of depression (P<0.05). The prognosis of patients with no negative emotions at the first, third, and sixth months after surgery was significantly better than that of patients with negative emotions (P<0.05).

Conclusions

Negative emotions have a significant impact on the prognosis of TNs. According to individual differences, targeted nursing intervention should be supplemented to stabilize a patient's emotions, improve compliance, and enhance quality of life.

Changes in Thyroid Antibodies after Microwave Ablation of Thyroid Nodules

PURPOSE

Microwave ablation (MWA) is a minimally invasive method for the thermal ablation of benign thyroid nodules and papillary thyroid cancer (PTC) and has shown promising results. The aim of this study was to investigate the impact of MWA on thyroid antibodies and associated influencing factors.

MATERIALS AND METHODS

A total of 119 patients, including 69 with benign thyroid nodules and 50 with PTC, underwent MWA between June 2019 and June 2021. The serum levels of (free) triiodothyronine, (free) thyroxine, thyrotropin, and antibodies against Tg (TGAb), thyrotropin receptors (TRAb), and thyroid peroxidase (TPOAb) were measured during the follow up.

RESULTS

One month after ablation, three patients (4.3%) in the benign group had hypothyroidism, and one (1.4%) had hyperthyroidism. Four patients (5.8%) had subclinical hypothyroidism, and two (2.9%) had subclinical hyperthyroidism. Among the PTC patients, two (4%) had hypothyroidism, and one (2%) had hyperthyroidism. Two patients (4%) had subclinical hypothyroidism, and one (2%) had subclinical hyperthyroidism. In the benign group, among patients with normal preablation antibodies, the postablation TGAb abnormal rate was 12.7%, the TPOAb level was 4.8%, and the TRAb level was 0%. Among PTC patients, the postablation TGAb abnormal rate was 11.4%, the TPOAb level was 8.7%, and the TRAb level was 4.0%. The cutoff value of preablation TGAb for predicting postoperative antibody abnormalities was 19.0 IU/mL, while that of TPOAb was 11.4 IU/mL.

CONCLUSIONS

MWA of thyroid nodules had little influence on thyroid function and antibodies. Elevations in TGAb, TPOAb, and TRAb beyond the normal ranges after MWA may be related to high preablation levels of TGAb and TPOAb.