Ultrasound ablation killing lesions is a new treatment for thyroid tumors

Ultrasound ablation killing lesions is a new treatment for thyroid tumors.   A number of guidelines and clinical studies recommend the use of microwave ablation technology for the treatment of benign nodules and low-risk papillary thyroid carcinoma.

In recent years, the incidence of thyroid tumors has been increasing year by year. Surgical treatment is still the first choice for the treatment of this disease. However, the vast majority of thyroid tumors are papillary microcarcinomas, which often take more than ten years or decades to grow and metastasize, and are low-risk lazy cancers. It would be a pity to cut off the thyroid gland and then take the medicine for life. Thermal ablation (radio frequency, microwave, laser) guided by imaging technology has the characteristics of less damage, faster recovery, better repeatability, and most of it does not affect the appearance. It can be used as most benign nodules and some thyroid micropapillary carcinomas. One of the alternative methods of surgical treatment.

A number of guidelines and clinical studies recommend the use of microwave ablation technology for the treatment of benign nodules and low-risk papillary thyroid carcinoma.

01  What is microwave ablation under ultrasound guidance?

In recent years, microwave thermal ablation has become one of the effective methods for the treatment of tumors. It is guided by ultrasound real-time monitoring to accurately deliver thermal ablation electrode needles into the tumor through skin puncture. The thermal effect generated by the needle tip is used in the tumor and the surrounding control area in a short time. A high thermal field is formed. When the edge temperature rises to 60°, the protein denatures and solidifies, causing tumor cell necrosis, and ultimately achieving the goal of “heat death” of the tumor. The clinical effect of this technology when applied to low-risk papillary thyroid microcarcinoma is definite.

02 What are the advantages of microwave ablation surgery?

Ultrasound-guided thermal ablation therapy is minimally invasive, effective, beautiful, and safe. It can effectively treat tumors while retaining the patient’s organ function to the greatest extent, protecting the patient’s immune function to the greatest extent, and ensuring the patient’s quality of life to the greatest possible extent. This is the highest requirement and philosophy of tumor treatment, conforms to the call of the World Health Organization for tumor treatment, and is also the goal pursued by doctors and patients.

03  What are the indications and contraindications for ultrasound ablation in the treatment of thyroid tumors?

Indications: The following 3 items must be met at the same time

1. Ultrasound revealed a single nodule, diameter ≤1cm, not close to the capsule (distance ＞2mm), FNA confirmed papillary carcinoma, and no suspicious lymph node metastasis in the neck area;

2. After assessment, the patient’s own conditions cannot tolerate surgical treatment or the patient subjectively refuses surgical treatment;

3. The patient has excessive thoughts and concerns that will affect his normal life and refuses clinical observation (the patient requires minimally invasive interventional therapy);

Contraindications: Excluded if any of the following is met

1. Suspicious metastatic lymph nodes were found in the cervical side area and confirmed by puncture;

2. There are large calcification foci in thyroid microcarcinoma;

3. Abnormal function of the contralateral vocal cords;

4. Severe coagulation mechanism disorder;

5. Severe heart and lung diseases;

04 Can ablation treatment completely kill tiny cancer nodules?

can! The tiny cancer nodules will be completely inactivated, and then gradually absorbed by the body, and eventually disappear completely, or only extremely tiny scar tissue is left in the thyroid.

05  Will ablation treatment affect thyroid function?

Ablation therapy is a “precise blow and targeted removal” of the lesion under ultrasound guidance. Normal thyroid tissue is basically not damaged, so it generally does not affect the secretion of thyroid hormones. Lifelong medication is not required after benign nodules. Surgical operation is to remove one or both thyroid glands, and the secretion of thyroid hormone is insufficient after surgery. Generally, it is necessary to take thyroxine tablets (youjiale) for life.

06 Will it recur after ablation?

Although papillary carcinoma is a low-grade malignant tumor, it is still cancer after all. Therefore, any treatment method, whether it is surgery or ablation, may have recurrence and metastasis after surgery, otherwise it is not a malignant tumor. However, the probability of recurrence and metastasis is low. In case of recurrence, a second ablation is also possible, of course, surgery can also be selected.

Regular review is required after surgery to monitor the effect. The review time was the next day, 1 week, 1 month, and 3 months after the operation, and then the ultrasound and thyroid function were reviewed every 3 months. After 2 years, it will be rechecked every 6 months.

Image-guided microwave thermal ablation therapy provides a relatively simple and minimally invasive supplementary method for thyroid diseases that meet the indications. Some patients can achieve similar therapeutic effects as surgical resection. Paying attention to standardized treatment plans and technical operations will help improve the safety and effectiveness of microwave thermal ablation therapy.

(source:internet, reference only)

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