A propensity-matched analysis of clinical outcomes between open thyroid lobectomy and high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules.
Surgery
; 165(1): 85-91, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30392858
ABSTRACT
BACKGROUND:
High-intensity focused ultrasound is a promising, nonoperative treatment for benign thyroid nodules. Our study aimed to compare treatment outcomes of single-session high-intensity focused ultrasound ablation with open lobectomy after propensity score matching.METHODS:
After propensity matching, we compared treatment-related morbidity, treatment time, duration of hospitalization, improvement in symptom score, cost, and acoustic parameters of consecutive patients who underwent high-intensity focused ultrasound ablation or lobectomy. All eligible patients completed the computerized, multidimensional voice program and Voice Handicap Index questionnaire before, and 3 and 6 months after treatment.RESULTS:
The matched cohort comprised 154 patients (77 in each group). Although treatment-related morbidity was comparable between the two groups (Pâ¯=â¯.368), treatment time (P <.001), duration of hospitalization (P <.001), and medical cost (P <.001) were less in the high-intensity focused ultrasound group. After high-intensity focused ultrasound ablation, the 6-month nodule shrinkage (mean ± SD) was 64% ± 26% and the 6-month symptom improvement score was comparable with lobectomy (Pâ¯=â¯.283). At 6 months, none of the acoustic parameters were changed from the baseline in both groups (P >.05), and the Voice Handicap Index questionnaire did not differ between the two groups (P >.05).CONCLUSION:
Despite having similar treatment-related morbidity and voice outcomes, there were possibly some advantages with high-intensity focused ultrasound during open lobectomy, including the avoidance of a neck scar, shorter treatment time and duration of hospitalization, and lower medical cost.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Tireoidectomia
/
Nódulo da Glândula Tireoide
/
Ablação por Ultrassom Focalizado de Alta Intensidade
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article