Clinical Trials Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 936-943
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.936
Comparative study on operative trauma between microwave ablation and surgical treatment for papillary thyroid microcarcinoma
Bin Xu, Ning-Ming Zhou, Wei-Tian Cao, Shu-Yan Gu
Bin Xu, Ning-Ming Zhou, Wei-Tian Cao, Shu-Yan Gu, Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, Shanghai 200240, China
Author contributions: Xu B and Zhou NM designed the research; Xu B and Cao WT performed the research; Gu SY contributed new analytic tools; Xu B analyzed the data; and Xu B, Zhou NM, and Cao WT wrote the paper.
Supported by Minhang District Natural Science Research Project, No. 2013MHZ003.
Institutional review board statement: The study was approved by the Ethics Committee of Fudan University Affiliated Shanghai Fifth People’s Hospital.
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry. The registration number is ChiCTR1800018512.
Informed consent statement: All patients gave informed consent to this study.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which selected by an in-house editor and fully peer-reviewed by external reviewers. It distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ning-Ming Zhou, MD, Chief Doctor, Department of Ultrasound, Fudan University Affiliated Shanghai Fifth People’s Hospital, 128 Ruili Road, Minhang District, Shanghai 200240, China. zhouningming@5thhospital.com
Telephone: +86-21-24289356
Received: September 27, 2018
Peer-review started: September 27, 2018
First decision: October 18, 2018
Revised: October 25, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 6, 2018
Processing time: 70 Days and 10.3 Hours
ARTICLE HIGHLIGHTS
Research background

The detection rate of papillary thyroid microcarcinoma (PTMC) has increased over time. Because thyroidectomy is prone to various complications, it can cause physical and mental harm to the patient. With the rapid development of minimally invasive techniques, microwave ablation is the main method of minimally invasive thyroid treatment, and is often used for the treatment of benign thyroid nodules. However, whether this method is indicated for the treatment of patients with PTMC is still controversial.

Research motivation

In this study, microwave ablation was used to treat patients with PTMC. It is hoped that microwave ablation can achieve the same effect as thyroid surgery, and can reduce the complications caused by thyroid surgery.

Research objectives

The aim of this study was to compare the efficacy of thyroidectomy and microwave ablation in the treatment of PTMC and their trauma to the patient’s body, to find a more appropriate treatment for patients.

Research methods

Eighty-seven patients diagnosed with papillary thyroid carcinoma were enrolled. There were 46 cases in the surgical group and 41 cases in the microwave ablation group. Microwave ablation and thyroidectomy were performed in each group. The operative time, intraoperative blood loss, hospitalization time, serum C-reactive protein (CPR), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were observed in the two groups. The changes of thyroid-related hormones and the postoperative complications of the two groups were observed 7 d and 30 d after surgery.

Research results

The operative time, intraoperative blood loss, hospitalization time, CPR, IL-6, and TNF-α in the surgical group were significantly higher than those in the microwave ablation group. The free triiodothyronine (FT3) and free thyroxin (FT4) levels in the surgical group were significantly lower than those in the microwave ablation group, while thyroid stimulating hormone (TSH) was significantly higher than that in the microwave ablation group. The complications of the two groups were similar.

Research conclusions

Microwave ablation for the treatment of PTMC has less stress response and higher safety. It can effectively shorten the hospitalization time of patients and improve the life quality. The thyroid function of patients after operation is not affected, so microwave ablation treatment of PTMC has a high clinical value.

Research perspectives

With the development of minimally invasive treatment, minimally invasive treatment methods are increasingly applied to various diseases, so that patients can achieve therapeutic goals with minimal surgical trauma, and minimize the impact of surgical trauma on the body. Minimally invasive surgery is a new technological innovation that still requires large sample and multi-center clinical research support to evaluate long-term safety and efficacy.