1.The efficacy and safety of radiofrequency ablation in papillary thyroid carcinoma: A systematic review and meta-analysis.
Wei Shuen Clarissa CHEONG ; Xin Yi Joy AU ; Ming Yann LIM ; Ernest Weizhong FU ; Hao LI ; Uei PUA ; Yong Quan Alvin SOON ; Yijin Jereme GAN
Annals of the Academy of Medicine, Singapore 2025;54(3):170-177
INTRODUCTION:
Radiofrequency ablation (RFA) avoids the complications of general anaesthesia, reduces length of hospitalisation and reduces morbidity from surgery. As such, it is a strong alternative treatment for patients with comorbidities who are not surgical candidates. However, to our knowledge, there have only been 1 systematic review and 3 combined systematic review and meta-analyses on this topic to date. This systematic review and meta-analysis seeks to evaluate the efficacy and safety of RFA in the treatment of papillary thyroid carcinoma (PTC) with longer follow-up durations.
METHOD:
PubMed, Embase and Cochrane databases were searched for relevant studies published from 1990 to 2021; 13 studies with a total of 1366 patients were included. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and Sandelowski et al.'s approach1 to "negotiated consensual validation" were used to achieve consensus on the final list of articles to be included. All authors then assessed each study using a rating scheme modified from the Oxford Centre for Evidence-Based Medicine.
RESULTS:
Pooled volume reduction rates (VRRs) from 1 to 48 months after RFA, complete disappearance rates (CDR) and complications were assessed. Pooled mean VRRs were 96.59 (95% confidence interval [CI] 91.05-102.13, I2=0%) at 12 months2-6 and 99.31 (95% CI 93.74-104.88, I2=not applicable) at 48 months.2,5 Five studies showed an eventual CDR of 100%.2,4,7-9 No life-threatening complications were recorded. The most common complications included pain, transient voice hoarseness, fever and less commonly, first-degree burn.
CONCLUSION
RFA may be an effective and safe alternative to treating PTC. Larger clinical trials with longer follow-up are needed to further evaluate the effectiveness of RFA in treating PTC.
Humans
;
Radiofrequency Ablation/methods*
;
Thyroid Cancer, Papillary/surgery*
;
Thyroid Neoplasms/surgery*
;
Treatment Outcome
;
Postoperative Complications/etiology*
2.Radiofrequency ablation of inferior turbinate in the treatment of allergic rhinitis in children.
Shilei PU ; Meizhen GU ; Hongming XU ; Xiaoyan LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):114-119
Objective:To investigate the safety and efficacy of submucous radiofrequency ablation of the inferior turbinate, and to provide a clinical basis for the surgical treatment of allergic rhinitis in children. Methods:Patients with obstructive sleep apnea syndrome and allergic rhinitis who were admitted to the Department of Otolaryngology Head and Neck Surgery of Shanghai Children's Hospital from January 2021 to December 2023 and underwent bilateral submucous radiofrequency ablation of the inferior turbinate and radiofrequency ablation of the adenoid tonsil were included in the study. Observational and statistical indexes were used to evaluate the curative effect. Results:A total of 51 cases were included in this study, and 43 cases were followed up for half a year. Submucous radiofrequency ablation of the inferior turbinate plus radiofrequency ablation of the adenoid tonsil achieved a good effect (total effective rate 93%), and there was a statistically significant difference in the preoperative and postoperative symptoms of the children(P<0.05). There were no complications such as bleeding, Eustachian tube injury, nasal adhesion, or nasal dryness. Conclusion:Under the premise of strict control of surgical indications, children with allergic rhinitis can be treated surgically. Inferior turbinate submucous radiofrequency ablation is more minimally invasive, effective, and safe, and can be used in clinical practice.
Humans
;
Turbinates/surgery*
;
Rhinitis, Allergic/surgery*
;
Radiofrequency Ablation/methods*
;
Child
;
Male
;
Female
;
Sleep Apnea, Obstructive/surgery*
;
Treatment Outcome
;
Catheter Ablation
;
Adolescent
3.The management of infantile laryngeal cysts.
Fan LOU ; Cheng MING ; Yan GAO ; Jinyan ZU ; Jing MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):120-123
Objective:To explore the therapeutic strategy for laryngeal cysts in infants. Methods:A retrospective analysis of the clinical data of 19 children with laryngeal cysts treated in Kunming Children's Hospital from January 2020 to January 2023. All patients were diagnosed through electronic laryngoscopy examination. Twelve neonates were admitted to the neonatal intensive care unit. Five of them received mechanical ventilation with tracheal intubation before surgery due to severe respiratory distress, and seven received oxygen therapy with a head mask. The remaining seven children were admitted to Department of Otolaryngology Head and Neck Surgery, of which three cases were treated with oxygen therapy through a mask during sleep due to frequent shortness of breath during sleep. All patients underwent low-temperature plasma radiofrequency ablation under general anesthesia to remove the cysts. Results:Three newborns were unable to have their tracheal tubes removed due to complications with pneumonia after surgery, while the rest of the children were able to have their tubes successfully removed after complete anesthesia, and no gastric tubes were placed. All postoperative respiratory difficulties in the children disappeared, and there were no complications such as bleeding, hoarseness, or laryngeal stenosis. Five pediatric patients had incomplete relief of laryngeal ringing symptoms one month after surgery, and electronic laryngoscopy diagnosed laryngeal softening. Regular follow-up is recommended. One child relapsed 4 months after surgery and underwent a follow-up surgery six months later without recurrence. Conclusion:Endoscopic low-temperature plasma radiofrequency ablation is an effective surgical method for treating laryngeal cysts, with a low postoperative recurrence rate. Laryngeal cysts may be accompanied by laryngeal softening, which may be a possible reason for the postoperative symptoms not improving.
Humans
;
Retrospective Studies
;
Cysts/surgery*
;
Laryngeal Diseases/surgery*
;
Infant
;
Laryngoscopy
;
Infant, Newborn
;
Male
;
Female
;
Radiofrequency Ablation
4.Clinical analysis of surgical treatment and postoperative efficacy in piriform sinus fistula with acute inflammatory period of children.
Yufeng GUO ; Xingqiang GAO ; Zhengmin XU ; Haiyan DENG ; Xiaohui WU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):158-162
Objective:To discuss the clinical efficacy of low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess for the treatment of congenital pyriform sinus fistula (CPSF) in the acute inflammatory period of children. Methods:Clinical data of 30 patients with CPSF in the acute inflammatory period who received low-temperature radiofrequency ablation assisted by endoscopy under laryngoscope, combined with resection and drainage of cervical abscess, from January 2018 to December 2023 were reviewed. After the operation, patients were followed up closely at different stages. All patients underwent color Doppler ultrasound and electronic laryngoscopy, and the results were analyzed. Results:All 30 children successfully completed the surgery without pharyngeal fistula, dysphagia, perifistula, or distal fistula infection, and the incision in the neck healed well. The follow-up survey ranged from 6 months to 2 years, and no recurrences were observed. Conclusion:Low-temperature radiofrequency ablation assisted by endoscopy combined with resection and drainage of cervical abscess is a promising method for treating CPSF in the acute inflammatory period. It is less traumatic, simple, safe, has a significant curative effect, and a low recurrence rate. This approach can be used as a supplementary operation for CPSF in children and provides a new way for clinical treatment.
Humans
;
Pyriform Sinus/abnormalities*
;
Abscess/surgery*
;
Drainage
;
Fistula/congenital*
;
Female
;
Male
;
Child
;
Radiofrequency Ablation
;
Treatment Outcome
;
Postoperative Period
;
Endoscopy
;
Laryngoscopy
;
Inflammation
;
Child, Preschool
5.Analysis the influencing factors and risk warning of the therapeutic efficacy of multi plane low temperature plasma radiofrequency ablation for OSAHS.
Xing LIU ; Kaiwei DONG ; Meng LIU ; Huachao LI ; Bo NING
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(9):871-876
Objective:To analyze the efficacy, influencing factors, and risk warning of multi-plane low-temperature plasma radiofrequency ablation(MLT-RFA) in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS). Methods:A total of 118 OSAHS patients admitted from October 2022 to June 2024 were selected as the research subjects. They were divided into mild group(n=46), moderate group(n=52), and severe group(n=20) according to the severity of their condition. MLT-RFA treatment was used for all patients. After surgery, the results of polysomnography(PSG) and the changes in the Calier Sleep Apnea Quality of Life Index(SAQLI) were observed before and after treatment. The incidence of complications after treatment was recorded, and the clinical efficacy of the patients was evaluated. At the same time, they were divided into a treatment effective group(n=106) and an ineffective group(n=12) according to their effects. The general clinical data of the two groups were compared, and binary logistics regression analysis was conducted to identify independent factors that affect treatment efficacy and construct a model. ROC curve analysis was used to evaluate the diagnostic efficacy of the model. Results:The treatment effectiveness rate of the mild group was 93.48%, the moderate group was 90.38%, and the severe group was 80.00%. There was no statistically significant difference in the treatment effectiveness rate among the three groups(P>0.05). The AHI of the mild group, moderate group, and severe group increased sequentially, while the LSaO2and SAQLI scores decreased sequentially. After treatment, the AHI of all three groups decreased compared to before treatment, while the LSaO2and SAQLI scores increased compared to before treatment, and the differences were statistically significant(P<0.05). The pre-treatment AHI of the effective group was lower than that of the ineffective group, and the pre-treatment LSaO2and SAQLI were higher than those of the ineffective group, with statistically significant differences(P<0.05). Pre-treatment LSaO2and pre-treatment SAQLI are independent factors affecting the efficacy of MLT-RFA(P<0.05). The AUC of pre-treatment LSaO2, pre-treatment SAQLI, and combined prediction were 0.907, 0.763, and 0.947, respectively, with sensitivities of 0.896, 0.840, and 0.917, and specificities of 0.833, 0.667, and 0.887, respectively. Conclusion:MLT-RFA has a significant effect on the treatment of OSAHS, and the AHI, LSaO2, and SAQLI of patients before treatment can predict the treatment effect, with LSaO2 and SAQLI being independent influencing factors. The combinerd prediction model exhibits high diagnostic efficiency, sensitivity, and specificity.
Radiofrequency Ablation/methods*
;
Plasma Gases
;
Sleep Apnea, Obstructive/surgery*
;
Polysomnography
;
Postoperative Complications/epidemiology*
;
Quality of Life
;
Severity of Illness Index
;
Treatment Outcome
;
Humans
6.Effect of Calcification on the Ultrasound-Guided Radiofrequency Ablation of Papillary Thyroid Carcinoma.
Yi-Ming LI ; Lin YAN ; Jing XIAO ; Ming-Bo ZHANG ; Yu-Kun LUO
Acta Academiae Medicinae Sinicae 2023;45(5):803-808
Objective To investigate the effect of calcification on the ultrasound-guided radiofrequency ablation(RFA)of papillary thyroid carcinoma(PTC).Methods We retrospectively analyzed the preoperative and follow-up data of 164 patients(182 nodules)with PTC treated by percutaneous ultrasound-guided RFA in the First Medical Center of Chinese PLA General Hospital from January 1,2018 to December 31,2021.The tumor status 12 months after RFA was taken as the endpoint event.The univariate Logistic regression analysis was employed to predict the influencing factors of incomplete ablation.The factors were then included in the multivariate Logistic regression analysis for prediction of the independent risk factors of incomplete ablation.Results The maximum nodule diameter(OR=1.16,95%CI=1.04-1.29,P=0.009)and calcification ratio >2/3(OR=19.27,95%CI=4.02-92.28,P<0.001)were the factors influencing the disappearance of lesion 12 months after RFA.Conclusions PTC with calcification can be treated with ultrasound-guided RFA.In the case of calcification ratio ≤ 2/3,this therapy demonstrates the effect equivalent to that of no calcification.
Humans
;
Thyroid Cancer, Papillary/surgery*
;
Retrospective Studies
;
Neoplasm Recurrence, Local
;
Radiofrequency Ablation/methods*
;
Calcinosis
;
Thyroid Neoplasms/pathology*
;
Ultrasonography, Interventional
8.Expert consensus on microwave ablation for benign breast nodules.
Chinese Journal of Internal Medicine 2023;62(4):369-373
Because mammary glands are regulated by endocrine factors, they are prone to various abnormalities and disorders. Breast nodules are common and occur frequently in clinical practice. The clinical management of breast nodules mainly includes follow-up observation, lesion biopsy, and surgical intervention, and surgical intervention is an effective treatment. Ultrasound-guided percutaneous microwave ablation is a new minimally invasive treatment technology developed in recent years. It has the advantages of short operation time, no scarring, less damage to the lactiferous duct, quick recovery, and good curative effects without bleeding. The establishment of an expert consensus on microwave ablation for benign breast nodules aims to provide a reliable clinical basis for microwave ablation of benign breast nodules, standardize the treatment process, and improve treatment efficacy, so as to serve as a reference for physicians in clinical practice.
Humans
;
Consensus
;
Microwaves/therapeutic use*
;
Catheter Ablation
;
Thyroid Nodule/surgery*
;
Radiofrequency Ablation
;
Treatment Outcome
9."Leverage pry-off method" for effective prevention of thermal injury during microwave ablation of benign thyroid nodules.
Feng Lin WU ; Qiao Zhi WU ; Wen Wei XU ; Zhi Hong WU ; Le Rong LIU ; Lin ZHOU
Journal of Southern Medical University 2023;43(1):122-127
OBJECTIVE:
To assess the safety and efficacy of"leverage pry-off method"for preventing thermal injury during microwave ablation of benign thyroid nodules.
METHODS:
From July, 2017 to September, 2019, a total of 348 patients with benign thyroid nodules underwent ultrasound-guided microwave ablation. For protecting from thermal injury during the ablation, "hydrodissection technique" was used in 174 of the patients (admitted from July, 2017 to August, 2018) and "leverage pry-off method" in the other 174 patients (admitted from September, 2018 to September, 2019). All the patients were followed up for 1 to 12 months after the operation for observation of severe complications and nodular residues.
RESULTS:
Ultrasound-guided microwave ablation was completed in all the 348 patients. The most common severe complication associated with the ablation was voice change, occurring in 3 cases (1.7%) in "hydrodissection technique" group and in 4 (2.3%) in the "leverage pry-off method" group, showing no significant difference between the two groups (P>0.05). During the follow-up, no significant difference was found in the rate of nodular residues between the "hydrodissection technique" group and "hydrodissection technique" group (9.8% vs 10.9% (P>0.05).
CONCLUSIONS
The "leverage pry-off method" is simple and effective for preventing thermal injury during microwave ablation of benign thyroid nodules.
Humans
;
Microwaves/therapeutic use*
;
Thyroid Nodule/surgery*
;
Burns
;
Hospitalization
;
Radiofrequency Ablation

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