Thyroid No Surgery 101: Thyroid Nodule Radiofrequency Ablation RFA Study from Austria.
Dobnig H. et al
Thyroid 28(4) 2018 p.472
DR.Guttler comments on this article
More evidence that thyroid RFA is a safe way to treat thyroid nodules without surgery. Why the FDA is holding up approval of these Korean thyroid friendly systems while the rest of the world is using them is hard to understand.
WE are close to geting approval in the states and will begin clinical trials and off label use soon.
Call 310-393-8860 or email to [email protected] for details of my evaluation and referral service to Europe and Korea for solid nodules or for my treatment of thyroid and parathyroid cysts in my center with ethanol PEI.
- Endocrinologists in Austria used local only to treat thyroid nodules with RFA.
- They gave the patient Ibuprofen PO 30 minutes before the procedure.
- No IV drugs were used.
- BP,EKG,SpO2,pulse, and respiration were monitored.
- 2 nurses were used.
- The treatment was done using the thyroid friendly Korean system with a short length probe 7 cm and thin hot tip 10-15 mm and thin electrode #18.
- StarMed Korea genarator
- 2 % lidocaine was used to infiltrate over the nodule and followed by injection of the pericapsular area above the nodule.
- Following the procedure a cold pack put on the neck.
- Observation for 30 minutes and 25 mg of predisolone followed by another dose of ibuprofen.
- 2 more doses of steroids given for the second day post RFA. and a few more pain pills.
- Pain minimal. 249/277 had no pain.22/277 had grade 1 pain.6/277 had grade 2 pain.4/277 had a hematoma in the muscle.2/277 had low BP.1/277 had postRFA diarrhea.local was used 0-3 times for those grade pain cases.
- Complications230/277 had no complications. 36/277 had minimal,9/277 had moderate reversible complications. and 2/277 had irrversible complicationsincluding one case of hypothyroidism and one wound infection requiring surgery.
- They conclude that the use of conscience sedation or even general anesthesia is not not justified for thyroid RFA.
- 12 months nodules 81% decrease in size.
- Symptoms decreased significantly.
- Cosmetic problems improved.
- duration of treatment was 35 minutes.
- 56 watts for 7 minutes was all the time needed to ablate.
- Short thin electrodes with #81 and 19 gauge hot tips for the neck area.
- All 277 cases had normal thyroid function post RFA but one becoming hypothyroid.