Microwave ablation and surgical resection of papillary thyroid microcarcinoma: comparative analysis of clinical efficacy, safety and economy

doi:10.3877/cma.j.issn.1672-6448.2018.04.008

Abstract

Abstract:

Objective

To compare the efficacy, safety and cost between ultrasound-guided percutaneous microwave ablation and surgical resection in patients with papillary thyroid microcarcinoma.

Methods

A total of 89 patients highly suspected papillary thyroid microcarcinoma by cervical ultrasonography were proved by ultrasound guided fine-needle aspiration biopsy in The Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to February 2017. Totally 49 patients underwent microwave ablation (microwave group) while 40 patients underwent surgical resection (surgical group). T test was used to compare operation time, hospitalization expenses and the hospitalization time between the microwave group and the surgical group. Chi-squared test was applied to compare complications rate between the two groups. T test was used to compare the level of thyroid-related hormone before and after operation in the two groups.

Results

In the microwave group, the operation time, the hospitalization expenses and the hospitalization time were less [(55.85±5.05) min vs (25.73±9.46) min, (25435.91±5763.35) CNY vs (11307.48±3884.62) CNY and (6.78±3.03) d vs (2.92±0.78) d]. These differences were statistically significant (t=-18.985, -13.084 and -7.747, P<0.001). No severe complications occurred in the two groups. The difference of complications rate between the two groups was not statistically significant [6.1% (3/49) vs 10.0% (4/40), χ²=-0.452, P=0.779]. The level of 3′-triiodothyronine (FT3) and 4′-triiodothyronine (FT4) were higher after the operation in the microwave group, but these differences were not statistically significant. The level of FT3 and FT4 were lower [(4.5±0.50) pmol/L vs (3.90±0.72) pmol/L, (13.94±2.41) pmol/L vs (12.69±2.88) pmol/L], while the level of TSH was higher [(3.66±6.29) mIU/L vs (10.12±15.61) mIU/L] after operation in the surgical group. These differences were statistically significant (t=6.214, P<0.001; t=2.808, P=0.008; t=-3.035, P=0.004).

Conclusions

Ultrasound-guided percutaneous microwave ablation is characterized by minimal invasion, good cosmetic effect, low cost and definite curative effect. It offered a new choice for the patients who refuse to undergo surgical resection.

Key words: Thyroid neoplasms, Ablation techniques, General surgery

Hangjun Chen, Chao Zhang, Pintong Huang. Microwave ablation and surgical resection of papillary thyroid microcarcinoma: comparative analysis of clinical efficacy, safety and economy[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(04): 275-280.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.04.008

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I04/275

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组别	例数	手术时间（min，±s）	住院费用（元，±s）	住院时间（d，±s）	并发症发生率[%（例/例）]
微波消融组	49	25.73±9.46	11 307.48±3884.62	2.92±0.78	6.1（3/49）
外科手术组	40	55.85±5.01	25 435.91±5763.35	6.78±3.03	10.0（4/40）
检验值	?	t=-18.985	t=-13.084	t=-7.747	χ²=-0.452
P值	?	<0.001	<0.001	<0.001	0.779

组别	例数	手术时间（min，±s）	住院费用（元，±s）	住院时间（d，±s）	并发症发生率[%（例/例）]
微波消融组	49	25.73±9.46	11 307.48±3884.62	2.92±0.78	6.1（3/49）
外科手术组	40	55.85±5.01	25 435.91±5763.35	6.78±3.03	10.0（4/40）
检验值	?	t=-18.985	t=-13.084	t=-7.747	χ²=-0.452
P值	?	<0.001	<0.001	<0.001	0.779

时间	微波消融组				外科手术组
时间	例数	FT3（pmol/L）	FT4（pmol/L）	TSH（mIU/L）	例数	FT3（pmol/L）	FT4（pmol/L）	TSH（mIU/L）
术前	49	4.21±0.45	12.66±1.42	1.68±0.89	40	4.50±0.50	13.94±2.41	3.66±6.29
术后	49	4.37±1.64	15.24±18.73	2.73±6.28	40	3.90±0.72	12.69±2.88	10.12±15.61
t值	?	-0.689	-0.976	-1.201	?	6.214	2.808	-3.035
P值	?	0.494	0.334	0.236	?	<0.001	0.008	0.004

时间	微波消融组				外科手术组
时间	例数	FT3（pmol/L）	FT4（pmol/L）	TSH（mIU/L）	例数	FT3（pmol/L）	FT4（pmol/L）	TSH（mIU/L）
术前	49	4.21±0.45	12.66±1.42	1.68±0.89	40	4.50±0.50	13.94±2.41	3.66±6.29
术后	49	4.37±1.64	15.24±18.73	2.73±6.28	40	3.90±0.72	12.69±2.88	10.12±15.61
t值	?	-0.689	-0.976	-1.201	?	6.214	2.808	-3.035
P值	?	0.494	0.334	0.236	?	<0.001	0.008	0.004

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