07 Laser-induced interstitial thermotherapy in treatment of solid nodules of thyroid Pobierz

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Opis:

Introduction. pending on the application of laser-induced interstitial thermotherapy (LITT) in the treatment of solid thyroid
nodules for today is the definition of indications and contraindications, techniques and technology performance, efficiency and
improved long-term results.
The aim of the study. Studing the effect of LITT on parathyroid tissue and functional capacity of thyroid gland, determining
the factors affecting the timing of replacement of host connective tissue and its capacity to develop evidence to reapply
thermotherapy.
Materials and methods. using the LITT there were treated 272 patients with a nodular goiter with no signs of cystic
degeneration. All patients – women from 22 to 68 years. The volume of nodules was within the range from 0.8 to 5.0 cm3. On
ultrasonic characteristics, in particular echoic nodules were: 46 – hypoechoic, 189 – isochoric and 37 – hyperechoic. There was
used a diode laser Lakhta Milon. LITT was performed on such parameters: the wavelength of 1060 nm, continuous operation,
output power ranging from 2.5 to 3.2 watts. LITT was controlled by ultrasound. Changes in the nodule, parathyroid tissue and
gland function after LITT was determined on the second day after 2 weeks, 1, 3, 6, 9 and 12 months after the procedure.
Results and discussion. on the second day after laser thermotherapy aseptic inflammation develops in nodules, but their size
increases on 25–30 %. Later, in a certain period the survey, the size of nodules decreased, rates of hormonal function did not
changed. 6 months after LITT with sizes of nodules up to 2 cm3 complete replacement of connective tissue occurred in all cases
of hypo- and isochoric nodes and 71% - hyperechoic, and in sizes from 2 to 5 cm3 – 75% of hypoechoic structures, 18 % and
isochoric there was no beneficial effect hyperechoic nodes. In cases of treatment failure called for the repeated LITT, after which
all patients had complete reduction of the nodule.
Conclusions. in the developed mode LITT does not cause destructive changes in parathyroid tissue and hormonal gland
function. Duration of regression and replacement of the nodule by connective tissue determines it’s echogenicity and volume.
Indications for re-use of thermotherapy is the residual tissue at the nodule

Rozmiar:

255.04 Kb

Autor:

Shidlovskyi V. A., Shidlovskyi A. V.

Wersja z dnia:

28.03.2014