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Вестник хирургии имени И.И. Грекова

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ЛАЗЕРИНДУЦИРОВАННАЯ ТЕРМОТЕРАПИЯ КИСТОЗНО-КОЛЛОИДНЫХ УЗЛОВ ЩИТОВИДНОЙ ЖЕЛЕЗЫ: ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ

https://doi.org/10.24884/0042-4625-2016-175-1-48-53

Аннотация

The authors studied the treatment results of application of the laser-induced thermotherapy method in 414 patients with nodular colloid goiter. Dynamics of the nodule sizes was estimated in 298 (72, 0%) patients. Dynamics of thyroid status was assessed in 132 (31, 8%) patients. The average size was reduced more than 60% among the nodules with the volume up to 1 cm³. In case of nodules with the volume more than 8 cm³, the average size was decreased more than 40%. The majority of nodules with the volume of 1 cm³ were reduced more than 50% (45 out of 80), other nodules 19 (23,8%) were decreased more than 75% and 12 nodules completely vanished. The nodules with the volume of 1-2 cm³ were reduced more than half of them on 50% (41 out of 71), the rest of the nodules - on 75% and more than fifth part of them. At the same time, there wasn’t noted the decrease more than 75% in the nodules with the volume of 4 cm ³. However, the volume decrease was observed among such nodules, the majority of the nodules were reduced more than a quarter. During this procedure the patients 305 (73,7%) felt some discomfort and low-intensive pain in area of manipulation. The pains were completely arrested in 289 patients in the end of this procedure, but aching continued in the case of 16 patients for more long time (from 12 to 24 hours). There was noted the temperature rise up to the level of low grade fever in 11 (2,7%) patients during 12-24 hours. Complications of laser-induced thermotherapy had 21 (5,1%) patients. An intracutaneous unstrained haematoma was defined in 15 patients in injection area. There was noted a skin burn in spot of the injection in 5 (1,2%) patients. Paresis of the vocal ligament took place in one patient (0,2%), but it was treated in phonopedist and mobility of the vocal ligament was restored. Hyperthyroidism was caused in two patients and, according to the authors, it could be associated with drug intake of “сordaron”.

Об авторах

В. Г. Петров
ГБУЗ ТО «Эндокринологический диспансер»
Россия


А. А. Нелаева
ГБУЗ ТО «Эндокринологический диспансер»
Россия


И. А. Хучашева
ГБУЗ ТО «Эндокринологический диспансер»
Россия


Е. В. Мелехин
ГБУЗ ТО «Эндокринологический диспансер»
Россия


Список литературы

1. Александров Ю. К., Могутов М. С., Патрунов Ю. П. и др. Малоинвазивная хирургия щитовидной железы. М.: Медицина, 2005. 288 с.

2. Александров Ю. К., Савенко М. Е., Яновская М. Е. и др. Возможности интерстициальной лазерной фотокоагуляции в лечении пациентов с субсантиметровыми узлами щитовидной железы // Материалы XIX Российского симпоз. с междунар. участием. Челябинск, 2010. С. 15-17.

3. Петров В. Г. Оптимизация оказания медицинской помощи пациентам с узловым зобом в регионе легкого йодного дефицита: Автореф. дис. … д-ра мед. наук. Челябинск, 2008.

4. Привалов В. А., Гиниатуллин Р. У., Ревель-Муроз Ж. А. и др. Разработка, экспериментальное обоснование метода лазерной деструкции в малоинвазивной хирургии щитовидной железы и его клиническая апробация // Лазерные технологии в медицине: Сб. науч. работ. Челябинск, 1999. С. 136-142.

5. Селиверстов О. В. Разработка и совершенствование методов лечения послеоперационного рецидивного зоба: Автореф. дис. … д-ра мед. наук. Челябинск, 2003. 28 с.

6. Файзахметов А. Б., Селиверстов О. В. Эффективность и безопасность лазериндуцированной интратканевой термотерапии узлового нетоксического зоба // Современные аспекты хирургической эндокринологии: Материалы XX Российского симпоз. с междунар. участием. Казань, 2012. С. 301-305.

7. AACE-AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi. Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules // Endocr. Pract. 2006. № 12. P. 63-102.

8. Alexander E. K., Hurwitz S., Heering J. P. et al. Natural history of benign solid and cystic thyroid nodules // Ann. Int. Med. 2003. № 138. P. 315-318.

9. Baek J. H., Lee J. H., Valcavi R. et al. Thermal ablation for benign thyroid nodules: radiofrequency and laser // Korean J. Radiol. 2011. Vol. 12, № 5. P. 525-540.

10. Bown S. G. Phototherapy in tumors // World J. Surg. 1983. Vol. 7. P. 700-709.

11. Chandrasekhar S. S., Randolph G. W., Seidman M. D. et al. Clinical practice guideline: improving voice outcomes after thyroid surgery // Otolaryngol. Head Neck. Surg. 2013. Vol. 148. P. S1-37.

12. Dossing H., Bennedbaek F. N., Hegedus L. Ultrasound-guided interstitial laser photocoagulation of an autonomous thyroid nodule: the introduction of a novel alternative //Thyroid. 2003. Vol. 13. P. 885-888.

13. Galofr´e J. C., Lomvardias S., Davies T. F. Evaluation and treatment of thyroid nodules: a clinical guide // Mount Sin. J. Med. 2008. Vol. 75. P. 299-311.

14. Gambelunghe G., Fede R., Bini V. et al. Ultrasound-guided interstitial laser ablation for thyroid nodules is effective only at high total amounts of energy: results from a three year- pilot study // Surg. Innov. 2013. № 20 (4). Р. 345-350.

15. Gharib H., Papini E., Paschke R. et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules // Endocr. Pract. 2010. Vol. 16, Suppl. 1. P. 1-43.

16. Hegedus L., Bonnema S. J., Bennedbaek F. N. Management of simple nodular goiter: current status and future perspectives // Endocr. Rev. 2003. Vol. 24. P. 102-132.

17. Herranz-González J., Gavilán J., Matínez-Vidal J. et al. Complications Following Thyroid Surgery // Arch. Otolaryngol. Head Neck. Surg. 1991. Vol. 117, № 5. P. 516-518.

18. Kim J. H., Lee H. K., Lee J. H. et al. Efficacy of sonographically guided percutaneous ethanol injection for treatment of thyroid cysts versus solid thyroid nodules // Am. J. Roentgenol. 2003. Vol. 180. P. 1723-1726.

19. Kondo T., Ezzat S., Asa S. L. Pathogenetic mechanisms in thyroid follicular-cell neoplasia // Nat. Rev. Cancer. 2006. Vol. 6. P. 292-306.

20. Livraghi T., Paracchi A., Ferrari C. et al. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results. Work in progress // Radiology. 1990. Vol. 175. P. 827-829.

21. McGahan J. P., Browning P. D., Brock J. M. et al. Hepatic ablation using radiofrequency electrocautery // Invest Radiol. 1990. Vol. 25. P. 267-270.

22. Pacella C. M., Bizzarri G., Guglielmi R. et al. Thyroid tissue: US-guided percutaneous interstitial laser ablation-a feasibility study // Radiology. 2000. № 217. P. 673-677.

23. Pacella C. M., Bizzarri G., Spiezia S. et al. Thyroid tissue: US-guided percutaneous laser thermal ablation // Radiology. 2004. Vol. 232. P. 272-280.

24. Papini E., Guglielmi R., Bizzarri G. et al. Treatment of benign cold thyroid nodules: a randomized clinical trial of percutaneous laser ablation versus levothyroxine therapy or follow-up // Thyroid. 2007. Vol. 17. P. 229-235.

25. Rienzo G., Surrente C., Lopez C. et al. Tracheal laceration after laser ablation of nodular goiter Thoracic Surgery Unit // Hospital, Lecce, Italy. Interactive Cardiovascular and Thoracic Surgery. 2011. Vol. 14, № 1. P. 115-116.

26. Rossi S., Di Stasi M., Buscarini E. et al. Percutaneous radiofrequency interstitial thermal ablation in the treatment of small hepatocellular carcinoma // Cancer J. Sci. Am. 1995. Vol. 1. P. 73-81.

27. Seifert J. K., Cozzi P. J., Morris D. L. Cryotherapy for neuroendocrine liver metastases // Semin. Surg. Oncol. 1998. Vol. 14. P. 175-183.

28. Seki T., Wakabayashi M., Nakagawa T. Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma: comparison with percutaneous ethanol injection therapy // Cancer. 1999. Vol. 85. P. 1694-1702.

29. Sugiura N., Takara K., Ohto M. et al. Percutaneous intratumoral injection of ethanol under ultrasound imaging for treatment of small heptocellular carcinoma // Acta Hepatol. Jpn. 1983. № 2. Р. 1920.

30. Valcavi R., Riganti F., Bertani A. et al. Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients // Thyroid. 2010. № 20. P. 1253-1261.


Рецензия

Для цитирования:


Петров В.Г., Нелаева А.А., Хучашева И.А., Мелехин Е.В. ЛАЗЕРИНДУЦИРОВАННАЯ ТЕРМОТЕРАПИЯ КИСТОЗНО-КОЛЛОИДНЫХ УЗЛОВ ЩИТОВИДНОЙ ЖЕЛЕЗЫ: ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ. Вестник хирургии имени И.И. Грекова. 2016;175(1):48-53. https://doi.org/10.24884/0042-4625-2016-175-1-48-53

For citation:


Petrov V.G., Nelaeva A.A., Khuchasheva I.A., Melekhin E.V. LASER-INDUCED THERMOTHERAPY OF COLLOIDAL CYSTIC THYROID NODULES: THE EFFICACY AND SAFETY. Grekov's Bulletin of Surgery. 2016;175(1):48-53. (In Russ.) https://doi.org/10.24884/0042-4625-2016-175-1-48-53

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