Thyroid No Surgery 2018: What are your options to avoid surgery with benign cystic or solid Nodules with either symptomatic or cosmetic issues

Thyroid No Surgery 2018: What are your options to avoid surgery with benign cystic or solid Nodules with either symptomatic or cosmetic issues

Thyroid No Surgery 2018: What are your options to avoid surgery with benign cystic or solid Nodules with either symptomatic or cosmetic issues

Thyroid No Surgery 2018: What are your options to avoid surgery with benign cystic or solid nodules with either symptomatic or cosmetic issues.After a complete endocrine evaluation it is determined that your nodule is not cancer you have a series of options.

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  1. Thyroid surgery: The standard treatment method since 19th century. The high complication rates then are markedly now lower now but in the hands of a low volume thyroid surgeon it is not acceptable.
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  3. The decision to remove a lobe where the nodule resides is less dangerous but still requires hospitalization pain and suffering for weeks. The half thyroid left may fail and you would be on thyroid hormone for life.
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  5. Total thyroidectomy has the most complications in the hands of your local low volume surgeon.This is where if you still intend to have surgery you need to find a high volume thyroid surgeon.

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  1. The best option is to seek out an expert thyroid surgeon. These are found in major university medical centers or in private practice such as my go to thyroid surgeon DR. Gary Clayman in Tampa Florida. High volume is > 25 totals a year have the lowest complication rate.
  2. Thyroid Ethanol Ablation PEI: Cystic or  complex cyst solid thyroid nodules can be ablated with ethanol. PEI is safe and much less expensive than  any surgery. Centers doing ethanol ablation include Mayo clinic, and privately at Santa Monica thyroid center, and Brittany Henderson in North Carolina at Wake Forrest, and other ECNU certified endocrinologists and some interventional radiologists.
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  5. Big thyroid cyst before and after PEI
  6. Your primary care physician if asked about PEI may have a negative view of the procedure. They tend to think it is painful and cause high complications rates.Both are not true.
  7. PEI is a simple office procedure lasting 10-15 minutes.The patients leaves after a short observation period. They return for ultrasound follow up and never need thyroid hormone after the procedure.No lifetime thyroid hormone treatment is a big bonus for PEI over surgery.
  8. The cost is 1/50th of surgery!
  9. Call my office for details of PEI evaluation and treatment. 310-393-8860 or thyroid.manager@protonmail.com Richard Guttler MD,FACE.
  10. PEI is also a main line treatment for recurrent nodal neck metastatic disease from papillary thyroid cancer, and recently has been considered a third arm to surgery and active surveillance for primary micro-papillary. Mayo clinic: DR Ian Hay.
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  12. Thyroid Radiofrequency ablation or Thyroid RFA. Thyroid RFA is not safe in the USA as only large bore long liver electrodes are available here. Thyroid friendly thin short electrodes are still undergoing FDA evaluation, and wont be available until middle or late 2018
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  14. Thyroid RFA is a proven safe method to ablate your thyroid cysts and solid nodules. Because PEI is less expensive and available in the US we send patients to Korea or Italy for thyroid RFA for just solid nodules with small amount of cyst fluid and treat the major cysts here in my office.
  15. How do you get to Korea or Italy for thyroid RFA if you decide to avoid surgery. The scar, hospital stay and recovery and the need for thyroid hormone are main reason to not have surgery.
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  17. Korea above and Reggio Emillia below
  18. I have a good relationship with my two teachers. Roberto Valcavi
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  20. in Reggio Emillia near Bologna Italy,
  21. and Dr.J H Baek
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  23. in Seoul Korea.
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  25. Asan Medical Center in Seoul Korea.
  26. I can do the initial evaluation in the states, and send my records to them. If they agree you need RFA thyroid ablation you can travel to see Dr.Valcavi and have the RFA in the Palmer Institute.
  27. The hotel and transfers are included in the $3500 EU fee. There is no down time as you are treated the first day and have an exit ultrasound the next day and then you can fly home or visit some of the great restaurants in Italy before returning.
  28. The Korean RFA treatment is done in the Asan Medical Center by Dr.Baek. All information is available at the Asan Medical center international patients center website.
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Monday – Friday
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(310) 393-8860