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Continuous, Large-Volume Hydrodissection to Protect Delicate Structures around the Thyroid throughout the Radiofrequency Ablation Procedure

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Alternative Title
Continuous, Large-Volume Hydrodissection to Protect Delicate Structures around the Thyroid throughout the Radiofrequency Ablation Procedure.
Abstract
Introduction: Small-volume hydrodissection liquid dissipates rapidly and confers only short-term protection during radiofrequency ablation (RFA) of benign thyroid nodules. The aim of this study was to establish a safe method for continuous, large-volume hydrodissection. Methods: A long needle was inserted and positioned outside the thyroid capsule; 5% glucose was injected to maintain a 3- to 5-mm continuous safety buffer. From October 2015 to July 2020, 166 patients underwent hydrodissection with different volumes, and ablation efficacy and complications associated with different liquid volumes (≤40 mL vs. >40 mL) were compared at 1-month postprocedure. Moreover, 20 mL liquid (equivalent to 250 mL in the human body) was injected around the thyroid of a rhesus monkey, after which CT scans were used to visualize the liquid’s fate and verify its safety. Results: The 51
patients with 10?40 mL injections and 116 patients with larger injections (45?450 mL) showed similar complete ablation rates (88.46% vs. 90.44%, p = 0.582), comparable 6-month VRR (82.79% vs. 76.62%, p = 0.079), and complication incidences, although the latter group had larger nodules (9.11 mL vs. 13.79 mL, p = 0.003), more energy delivered (3.44 kcal vs. 6.04 kcal, p < 0.001), and longer operation times (51.37 min vs. 69.2 min, p < 0.001). In the animal experiment, the 20 mL of liquid diffused quickly (within 10 min) from the vicinity of the thyroid to the mediastinum and retropharyngeal space. It was observed in the kidneys at 10 min and disappeared from the neck and chest space by 24 h. Conclusions: Continuous, large-volume hydrodissection can protect the delicate structures around the thyroid throughout the RFA procedure and might be beneficial in large thyroid nodule ablation.
Author(s)
백정환LianMaRenTanTongWuYaoZheng
Issued Date
2021
Type
Article
Keyword
Benign thyroid nodulesHydrodissectionInterventional ultrasonographyRadiofrequency ablationUltrasound-guided ablation
DOI
10.1159/000519625
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8422
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2614755199&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Continuous,%20Large-Volume%20Hydrodissection%20to%20Protect%20Delicate%20Structures%20around%20the%20Thyroid%20throughout%20the%20Radiofrequency%20Ablation%20Procedure&amp;offset=0&amp;pcAvailability=true
Publisher
European Thyroid Journal
Location
스위스
Language
한국어
ISSN
2235-0640
Citation Volume
10
Citation Number
6
Citation Start Page
495
Citation End Page
503
Appears in Collections:
Medicine > Medicine
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