应用激光的甲状腺病变部分切除术

可用于不适宜外科手术治疗的病人

  2002年6月21日─在2002年6 月19日召开的第84届内分泌协会年会上有一报告报导了超声引导的激光部分切除术用于不适宜外科手术治疗的甲状腺肿大压迫或甲状腺功能亢进或退化性的甲状腺癌的治疗。

  「激光部分切除术可诱导界线清楚的甲状腺病变凝固性坏死,不管组织特征。」

  来自意大利罗马Ospedale Regina Apostolorum, Albano的 Claudio M. Pacella及同事写道。「病人能够很好的忍受这种手术,治疗后甲状腺病变明显的变小。」

  此项研究在12位自愿有高度外科手术风险的甲状腺病人中进行:3位有压迫症状的结节性甲状腺肿,8位甲状腺功能亢进巨大的甲状腺肿,和1位用传统治疗方法难以见效的退化性甲状腺癌。

  在此项研究中虽然有2位病人抱怨有烧疼(停止照射后疼痛消失),超声引导的激光部分切除术能够很好的被耐受,而且没有局部并发症。治疗后超声检查显示激光照射区域有边界清楚的高回声区。经过3个月的治疗病人的结节的平均体积从21+/-18毫升减小到10+/-8毫升,平均减少了45+/-16%。

  「激光部分切除术在甲状腺肿瘤中和伴有压迫症状的良性病变的治疗中将会成为一种很好的手段。」研究者写到。

Laser Thermal Ablation Debulks Thyroid Lesions

Effective in Poor Surgical Candidates

By Laurie Barclay, MD
WebMD Medical News

Reviewed by Gary D. Vogin, MD

June 21, 2002 -- Ultrasound-guided laser thermal ablation was effective for debulking compressive or hyperfunctioning thyroid nodules or anaplastic thyroid carcinoma in poor surgical candidates, according to a presentation June 19 at Endo 2002, the 84th annual meeting of The Endocrine Society.

"Laser thermal ablation induced a well-defined coagulative necrosis of thyroid lesions regardless of their histologic features," write Claudio M. Pacella from Ospedale Regina Apostolorum, Albano, Rome, Italy, and colleagues. "The procedure was well tolerated and caused a significant debulking of the treated lesions."

Twelve volunteer patients who were poor surgical risks included three with nodular goiters causing compressive symptoms, eight with huge hyperfunctioning thyroid nodules, and one with anaplastic thyroid carcinoma refractory to conventional therapy.

Laser thermal ablation using ultrasound guidance was well tolerated without local complications, although two patients complained of a burning pain that disappeared when irradiation ceased. After treatment, ultrasound revealed a well-defined hypoechoic zone corresponding to irradiated areas. Mean nodule volume decreased from 21+/-18 ml at baseline to 10+/-8 ml three months after treatment, with mean volume reduction of 45+/-16%.

"Laser thermal ablation could be a therapeutic tool for highly selected problems in the treatment of thyroid tumors or benign lesions [causing] compressive symptoms," the authors write.


© 2002 WebMD Inc. All rights reserved.

    
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