Thyroid No Surgery 101: Mayo Clinic does Thyroid RFA for Benign Nodules with the Large #17 Long Electrode.
Comments by Dr.Guttler
The main problem with this study is the meager reductions seen compared to the results by the Koreans and Italians.
Compare the short electrode with the long one Mayo clinic used.
The large #17 electrode poses problems with bleeding and because of the size the risk of complications. These were a factors in a less than mean 50% reduction in size. There is to much left to regrow. Also the autonomous nodule will surely regrow without complete ablation.
I am working with the Korean #18 and 19 small electrode and the short length allow for better control in the small space that is the neck. The results on the volume reduction with the smaller gauge electrodes used by the Koreans have been in the 80-95 % range.
The present state of Thyroid RFA is to go to Korea or Italy.
Mayo clinic is not ready for my patients for thyroid nodules by RFA at the present time.
Richard Guttler MD,FACE,ECNU
Call me for details of how to get evaluated.
Summary of the article:
Outcomes of Radiofrequency Ablation Therapy for Large Benign Thyroid Nodules: A Mayo Clinic Case Series
1. 14 patients
2.All the patients declined surgery or were poor surgical candidates.
3. Volume, compressive symptoms, cosmetic concerns, and thyroid function.
4.Maximum Volume reduction was 45%. ( 24 to 14 ml.) at 6 months.
5. No change in thyroid function.
6. 1/14 with subclinical hyperthyroidism due to toxic adenoma, thyroid function normalized 4 months after ablation of the toxic nodule.
7. Compressive symptoms resolved in 8 of 12 patients (67%) and improved in the other 4 (33%).
8. Cosmetic concerns improved in all 8 patients.
9. The procedure had no sustained complications.
10. It induces a substantial volume reduction of predominantly solid TNs, improves compressive symptoms and cosmetic concerns, and does not affect normal thyroid function.
11. Radiofrequency ablation has an acceptable safety profile and should be considered as a low-risk alternative to conventional treatment of symptomatic benign TNs.