Clinical Trials Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 936-943
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.936
Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma
Bin Xu, Ning-Ming Zhou, Wei-Tian Cao, Shu-Yan Gu
Bin Xu, Ning-Ming Zhou, Wei-Tian Cao, Shu-Yan Gu, Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, Shanghai 200240, China
Author contributions: Xu B and Zhou NM designed the research; Xu B and Cao WT performed the research; Gu SY contributed new analytic tools; Xu B analyzed the data; and Xu B, Zhou NM, and Cao WT wrote the paper.
Supported by Minhang District Natural Science Research Project, No. 2013MHZ003.
Institutional review board statement: The study was approved by the Ethics Committee of Fudan University Affiliated Shanghai Fifth People’s Hospital.
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry. The registration number is ChiCTR1800018512.
Informed consent statement: All patients gave informed consent to this study.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which selected by an in-house editor and fully peer-reviewed by external reviewers. It distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ning-Ming Zhou, MD, Chief Doctor, Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, 128 Ruili Road, Minhang District, Shanghai 200240, China. zhouningming@5thhospital.com
Telephone: +86-21-24289356
Received: September 27, 2018
Peer-review started: September 27, 2018
First decision: October 18, 2018
Revised: October 25, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 6, 2018
Processing time: 70 Days and 10.3 Hours
Abstract
AIM

To compare the effect and postoperative trauma of ultrasound-guided percutaneous microwave ablation and surgical resection in the treatment of papillary thyroid microcarcinoma (PTMC).

METHODS

Eighty-seven patients with PTMC treated at Fudan University affiliated Shanghai Fifth People’s Hospital were enrolled as subjects. The patients were divided into a microwave ablation group (41 cases) and a surgical group (46 cases). The operative time, intraoperative blood loss, length of hospital stay, serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), thyroid-related hormonal changes, and complications 7 d and 30 d after surgery were observed.

RESULTS

The operative time, intraoperative blood loss, and length of hospital stay in the surgical group were significantly higher than those in the microwave ablation group (P < 0.05). The levels of CRP, IL-6, and TNF-α in the surgical group were significantly higher than those in the microwave ablation group (P < 0.05). The free triiodothyronine (FT3) and free thyroxin (FT4) levels in the surgical group were significantly lower than those in the microwave ablation group (P < 0.05). However, the postoperative thyroid stimulating hormone (TSH) level was significantly higher than that in the microwave ablation group (P < 0.05). There were significant interactions between the FT3, FT4, and TSH 7 d and 30 d after operation and the treatment methods (P < 0.05). There was no significant difference in the complications between the two groups (P > 0.05).

CONCLUSION

Microwave ablation for papillary microcarcinoma of the thyroid gland has less trauma to the body, quicker recovery, and no scars. It can effectively shorten the length of hospital stay and improve the quality of life of patients.

Keywords: Thyroidectomy; Body trauma; Ultrasound; Microwave ablation; Papillary thyroid microcarcinoma

Core tip: Although thyroidectomy is the standard treatment for papillary thyroid microcarcinoma (PTMC), it causes great trauma to the patient’s body. In recent years, there have been reports on microwave ablation for patients with PTMC, but the efficacy is not certain. This study aimed to compare the efficacy and the impact on body trauma using ultrasound-guided percutaneous microwave ablation for PTMC and surgical resection. The results showed that microwave ablation for PTMC has less trauma, quicker recovery, and no scars, which can effectively shorten the hospitalization time and improve the quality of life.