Thyroid No Surgery 101; 7 Year PEI Study for Thyroid Cysts
A 7-year follow-up of patients with thyroid cysts and pseudocysts treated with percutaneous ethanol injection: volume change and cost analysis
The nodule is emptied of its liquid contents before anesthetic is injected.
The distribution of alcohol within the cyst creates a hyperechoic image which rapidly disappears.
Mean values ± SD of sex-specific reduction of cystic volume at 84 months expressed in percentages
Mean values ± 2SE of cystic volumes at the various follow-up. * p < 0.001; the student T-Test (two tailed); before treatment. † p < 0.001; the student T-Test (two tailed); 12 months after treatment.
US follow-up after treatment: note the residual cystic area.
1.Thyroid cysts and pseudocysts, or hemorrhagic cysts, are quite frequent thyroid pathologies.
2.Surgical therapy has always been the treatment of choice in this pathology, but percutaneous ethanol injection (PEI) is becoming still more common.
3.The aim of this study was to evaluate the efficacy of PEI in reducing thyroid cyst volume 12 and 84 months after treatment and to compare cost-benefit to that of surgical treatment.
4.The study includes 110 consecutive patients, who all underwent PEI after cytological analysis had excluded the presence of neoplasia.
5. All patients had refused surgical treatment.
6. Each patient received an average of 5.3 ± 2.7 PEI treatments.
7. After 12 months, volume was reduced by 82.6% and after 84 months by 93.03%.
8. Dysphonia occurred in 2 cases of which one resolved spontaneously and one received cortisone therapy.
9. The cost of PEI treatment is considerably lower than the cost of surgical therapy (the cost saving in our patient population was about €200,000).
10.PEI should therefore be preferred to surgical treatment due to its efficacy and lower cost.
Early 2009 study.Today usually 1 or 2 is enough to get results.
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