title: Interstitial laser photocoagulation (ILP) of benign cystic thyroid nodules--a prospective randomized trial.
abstract: BACKGROUND
  Recurrence rate, after aspiration, in cystic thyroid nodules is very high. Interstitial laser photocoagulation (ILP) is a minimally invasive procedure that reduces the need for surgery in patients with a benign solid thyroid nodule.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the efficacy of ILP on remission rates in recurrent, predominantly cystic thyroid nodules.
  
  
  METHODS
  Forty-four consecutive outpatients with a symptomatic, recurrent, and cytologically benign cystic (cyst volume ≥ 2 mL) thyroid nodule were randomized to a single aspiration with (n = 22) or without (n = 22) subsequent ILP and followed up after 1, 3, and 6 months.
  
  
  RESULTS
  Successful outcome (cyst volume ≤ 1 mL) was obtained in 15 of 22 (68%) patients in the ILP group, compared to 4 of 22 (18%) in the aspiration group (P = .002). In the ILP group, the solid part of the nodule was reduced from a median of 1.8 to 1.0 mL (P = .02). In the aspiration-alone group, neither the cyst volume nor the solid nodule volume was significantly reduced. The reduction in median visual analog score (0-10 cm) for pressure symptoms was significantly higher in the ILP group (from 3.0 to 0.0 cm) than in the aspiration-alone group (from 4.0 to 3.5 cm) (P = .006, between groups). No major side effects occurred, and thyroid function was unaffected throughout.
  
  
  CONCLUSIONS
  US-guided aspiration and subsequent ILP of benign recurrent predominantly cystic thyroid nodules is safe. It significantly reduces recurrence rate, the volume of the solid nodule component, and pressure symptoms. ILP constitutes an important alternative to surgery in such patients.
authors.affiliation: Department of Otorhinolaryngology and Neck Surgery, Odense University Hospital, DK-5000 Odense C, Denmark.
authors.forename: Helle
authors.initials: H
authors.lastname: Døssing
authors.forename: Finn Noe
authors.initials: FN
authors.lastname: Bennedbæk
authors.forename: Laszlo
authors.initials: L
authors.lastname: Hegedüs
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000009:adverse effects; D003560:Cysts / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000517:prevention & control; D012074:Remission Induction; D013396:Suction / Q000009:adverse effects; D013961:Thyroid Gland / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016606:Thyroid Nodule / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D047368:Tumor Burden