title: Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation.
abstract: OBJECTIVE
  Nodular goiter is one of the most common benign lesions in thyroid nodule. The main treatment of the disease is still the traditional surgical resection, however there are many problems such as general anesthesia, surgical scar, postoperative thyroid or parathyroid function abnormalities, and high nodules recurrence rate in residual gland. The purpose of this study was to compare the efficacy, safety, and cost-effectiveness of 2 treatment methods, surgery and radiofrequency ablation, for the treatment of benign thyroid nodules.
  
  
  METHODS
  From May 2012 to September 2013, 200 patients with nodular goiters who underwent surgery (group A) and 200 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) hyperfunctioning nodules related to thyrotoxicosis, and 4) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18-ga internally cooled electrode were used. We compared the 2 groups in terms of efficacy, safety, and cost-effectiveness during a 1-year follow-up.
  
  
  RESULTS
  After radiofrequency ablation, the nodule volume decreased significantly from 5.4 to 0.4 mL (P = .002) at the 12-month follow-up. The incidence of complications was significantly higher from surgery than from radiofrequency ablation (6.0% versus 1.0%, P = .002). Hypothyroidism was detected in 71.5% of patients after surgery but in none following radiofrequency ablation. The rate of residual nodules (11.9% versus 2.9%, P = .004) and hospitalization days was significantly greater after surgery (6.6 versus 2.1 days, P < .001), but the cost difference was not significant.
  
  
  CONCLUSIONS
  Surgical resection and radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules.
authors: From the Departments of Ultrasound (Y.C., L.W., X.Z.) yche1964@163.com radbaek@naver.com.
authors: Y
authors: Y
authors: Che
authors: Laparoscopic Surgery (S.J.).
authors: S
authors: S
authors: Jin
authors: Pathology (C.S.), First Affiliated Hospital of Dalian Medical University, Dalian, China.
authors: C
authors: C
authors: Shi
authors: From the Departments of Ultrasound (Y.C., L.W., X.Z.).
authors: L
authors: L
authors: Wang
authors: From the Departments of Ultrasound (Y.C., L.W., X.Z.).
authors: X
authors: X
authors: Zhang
authors: College of Basic Medical Sciences and Institute of Cancer Stem Cell (Y.L.), Dalian Medical University, Dalian, China.
authors: Y
authors: Y
authors: Li
authors: Department of Radiology and Research Institute of Radiology (J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea yche1964@163.com radbaek@naver.com.
authors: J H
authors: JH
authors: Baek
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006042:Goiter / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome