[Percutaneous ethanol sclerotherapy of non-toxic nodular goiters--a clinical study of 76 patients].
BACKGROUND
Ultrasonography-guided percutaneous ethanol injection (PEI) therapy is a new method for treating nodular goiters.


METHODS
76 patients with nontoxic nodular goiter (65 women, 11 men, mean age 49 years) underwent PEI in order to avoid surgery. In the first 14 patients with cystic nodule one session, while in the remaining 36 patients 3-8 sessions were performed. In each session after evacuation of the cysts half volume of absolute alcohol was injected into the nodule. In the cases of the 26 solid nodules each patient received a mean total dose of 0.98 ml (range 0.34-1.77 ml) ethanol per ml nodular volume. Ethanol was injected in a mean of 3.9 (range 2-8) sessions for solid nodules. Success was defined as shrinkage of the nodule to half or less compared to the pretreatment volume on 4.5 months and every later follow-up occasion.


RESULTS
No serious side effects occurred. 2 previously operated patients became hypothyroid. In the case of cystic nodules treated on one session, in 4 of 14 cases the therapy was unsuccessful. In patients treated on multiple occasions the success rate was significantly (p = 0.02, chi 2(1) = 5.06) higher; in 34 of 36 cases. PEI was successful in 25 of 26 patients with solid nodules. A continuous shrinkage of the nodule was observed in those 25 patients who were followed for at least 2 years: the volume of the nodule was 35% at 1.5 month, 29% at 4.5 month, 21% at 1 year and 17% of pretreatment volume at 2 years follow-up.


CONCLUSIONS
PEI should be reserved for patients who cannot or will not undergo surgery. On the other hand, patients with recurrent nodular goiter requiring surgery form a subset where PEI can be proposed.
Solymosi
Tamás
T
mosolyis@axelero.hu
D000328:Adult; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006044:Goiter, Nodular / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D000431:Ethanol