Year 2015 Vol. 23 No 3




SHEE "Ternopil State Medical University named after I.Y. Horbachevsky of MPH of Ukraine",

Objectives. To study the possibility of using the laser interstitial thermotherapy (LITT) in the treatment of the nodular euthyroid goiter and factors influencing its efficacy.
Methods. Using LITT 134 patients with benign solitary thyroid nodes had been treated. Single silica fiber, the output power of 2,8-3,2 Watts, continuous mode of radiation, wavelength of 1060 nm, continuous ultrasound guidance had been used. Changes in the structure and volume of nodules according to the ultrasonography data were studied within the 1th day, in 2 weeks, 1, 3, 6, 9, 12 and 15 months, respectively. The gland function and level of antibodies to thyroid peroxidase were determined by standard tests prior treatment, 1 and 6 months after treatment. The long-term results were studied three years afterwards.
Results. After 24 hours the volume of nodes increased on the average to 12,2±1,21% (p <0,05). In subsequent periods of observation the sizes of nodes reduced. The final assessment of the complete replacement of nodes on the scar tissue occurred in 128 (95,5%) cases, and the volume of nodes reduced from 3,02 cm3 (range 1,2-10,2) up to 0,57 (range of 0,1-1,3; p<0,001).
Unsatisfactory result was registered in 6 (4,5%) cases without any complications. At control survey (36 months after) the volume of scar tissue remained unchanged and the parameters of thyrotropic hormone, antibodies to thyroid peroxidase were within the normal range in 68 cured patients.
Conclusion. Laser thermotherapy is considered to be a highly effective, minimally invasive, safe and inexpensive method of outpatient treatment of the nodular goiter. Its effectiveness depends on the echogenicity and volume of nodes. It can be used as an independent method of treatment in the period from clinically significant node up to the development of the compression syndrome. In some cases laser interstitial thermotherapy lets to avoid possible surgical treatment.

Keywords: thyroid, nodular goiter, ultrasonography, treatment, antibodies, laser interstitial thermotherapy, efficiency
p. 268-274 of the original issue
  1. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, Vitti P; AACE/AME/ETA Task Force on Thyroid Nodules. 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: executive summary of recommendations. Endocr Pract. 2010 May-Jun;16(3):468-75.
  2. Papini E, Bizzarri G, Pacella CM. Percutaneous laser ablation of benign and malignant thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2008 Oct;15(5):434-9. doi: 10.1097/MED.0b013e32830eb89a.
  3. Barbaro D, Orsini P, Lapi P, Pasquini C, Tuco A, Righini A, Lemmi P.Percutaneous laser ablation in the treatment of toxic and pretoxic nodular goiter. Endocr Pract. 2007 Jan-Feb;13(1):30-36.
  4. Amabile G, Rotondi M, Pirali B, Dionisio R, Agozzino L, Lanza M, Buonanno L, Di Filippo B, Fonte R, Chiovato L. Interstitial laser photocoagulation for benign thyroid nodules: time to treat large nodules. Lasers Surg Med. 2011 Sep;43(8):797-803. doi: 10.1002/lsm.21114.
  5. Cakir B, Ugras NS, Gul K, Ersoy R, Korukluoglu B. Initial report of the results of percutaneous laser ablation of benign cold thyroid nodules: evaluation of histopathological changes after 2 years. Endocr Pathol. 2009 Fall;20(3):170-6. doi: 10.1007/s12022-009-9081-83.
  6. Piana S, Riganti F, Froio E, Andrioli M, Pacella CM, Valcavi R. Pathological findings of thyroid nodules after percutaneous laser ablation: a series of 22 cases with cyto-histological correlation. Endocr Pathol. 2012 Jun;23(2):94-100. doi: 10.1007/s12022-012-9192-0.
  7. Papini E, Rago T, Gambelunghe G, Valcavi R, Bizzarri G, Vitti P, De Feo P, Riganti F, Misischi I, Di Stasio E, Pacella CM.Long-term efficacy of ultrasound-guided laser ablation for benign solid thyroid nodules. Results of a three-year multicenter prospective randomized trial. J Clin Endocrinol Metab. 2014 Oct;99(10):3653-9. doi: 10.1210/jc.2014-1826.
  8. Dǿssing H, Bennedbæk FN, Hegedüs L. Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules. Eur J Endocrinol. 2011 Jul;165(1):123-8. doi: 10.1530/EJE-11-0220.
  9. Papini E, Bizzarri G, Pacella CM. Percutaneous laser ablation of benign and malignant thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2008 Oct;15(5):434-9. doi: 10.1097/MED.0b013e32830eb89a.
  10. Gambelunghe G, Fede R, Bini V, Monacelli M, Avenia N, D'Ajello M, Colella R, Nasini G, De Feo P. 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 Aug;20(4):345-50. doi: 10.1177/1553350612459276.
  11. Valcavi R, Riganti F, Bertani A, Formisano D, Pacella CM. Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients. Thyroid. 2010 Nov;20(11):1253-61. doi: 10.1089/thy.2010.0189.
  12. Gambelunghe G, Bini V, Stefanetti E, Colella R, Monacelli M, Avenia N, De Feo P. Thyroid nodule morphology affects the efficacy of ultrasound-guided interstitial laser ablation: a nested case-control study. Int J Hyperthermia. 2014 Nov;30(7):486-9. doi: 10.3109/02656736.2014.963701.
Address for correspondence:
46001, Ukraina, g. Ternopol, maydan Voli, d. 1,
GVUZ "Ternopolskiy gosudarstvennyiy meditsinskiy universitet
imeni I. Y. Gorbachevskogo, MOZ Ukrainyi", kafedra khirurgii 2
tel.: 380 352 52-44-92,
Shidlovskyi Aleksandr Viktorovich
Information about the authors:
Shidlovskyi A.V. PhD, an associate professor of the surgery chair №2 SHEE "Ternopil State Medical University named after I.Y.Horbachevsky", MPH of Ukraine.
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