Endocrine Abstracts

Purpose: To evaluate the technical feasibility, efficacy, and safety of the anterolateral hydrodissection (ALHD) technique in radiofrequency ablation (RFA) for benign thyroid nodules.

Methods: Between November 2019 and April 2020, 39 patients underwent 41 sessions of RFA with ALHD technique for treatment of benign thyroid nodules. ALHD was performed with cold (0°C–4°C) 5% dextrose solution during RFA to minimize pain and secure sufficient safety margins from critical neck structures. The initial ablation ratio (IAR) was measured to evaluate the technique’s efficiency. Ultrasound examinations, symptoms, and cosmetic scores were evaluated pre-procedure and at 6- and 12-month post-procedure. Procedure-related pain during RFA and complications were evaluated.

Results: The mean index nodule volume was 20.5±21.6 ml. ALHD was technically feasible in all patients. The mean IAR was 90.7±8.3%, and significant reductions in mean nodule volume were noted at 6- and 12-month follow-up (P<0.001, 63.9±19.0%, and 76.3±18.9%, respectively). After the procedures, symptom and cosmetic scores showed significant improvement at 6- and 12-month follow-up (P<0.001). Pain during the procedure was well-controlled with ALHD in all patients. There was no additional lidocaine injection after the initial use of 5–10 cc of lidocaine at the start of the procedure in all patients. Transient voice change was observed in one patient, but the patient recovered spontaneously within 30 minutes.

Conclusion: The ALHD technique was technically feasible in all patients and effective for achieving 90.7% IAR. The ALHD technique also had a pain-relieving effect, resulting in lower amount of lidocaine administration during the procedure.