The thyroid gland is the largest endocrine gland in the body and is crucial in promoting the basic metabolism, growth and development of the organism. It is distinctly different from other systems in the human body (such as the respiratory system, etc.), but is closely linked with the nervous system, interacting and cooperating with each other, and is known as the two major biological information systems. Without their close cooperation, the internal environment of the organism cannot maintain relative stability The physiological functions of thyroid hormones are mainly as follows
1.Promote metabolism, make most tissues consume more oxygen, and increase heat production.
2. Promote growth and development, which is essential for the development of long bones, brain and reproductive organs, especially during infancy. Lack of thyroid hormone at this time will suffer from cretinism.
3.Increase the excitability of the central nervous system.
In addition, it also strengthens and regulates the effects of other hormones, accelerates the heart rate, strengthens the heart contraction force and increases the cardiac output. Recent studies have shown that the rate of thyroid disease is very high and even affects people’s physical and mental health. Among them, nodular thyroid disease is the most common, the incidence of the general population is 4-7%, but recently the incidence of hospital health check-ups found to have increased suddenly to 30%-69%, about 250,000 new patients in the United States each year, and 5-10% of malignant nodules.
Diagnosis.
A physical examination of the thyroid gland usually begins with an ultrasound examination. After abnormalities are found, further laboratory tests, puncture biopsies or nuclear scans are performed as the doctor knows, and further treatment options are chosen based on the results.
Diffuse thyroid diseases are mostly internal diseases, and the endocrinologist will determine whether and how to administer medication based on the test results and follow up regularly for observation. In some cases, the benignity or malignancy of the thyroid gland can be determined by ultrasound examination, while in others, the diagnosis can be made by pathological examination of some of the tumor tissues extracted by puncture if they cannot be identified by conventional ultrasound. Since the thyroid gland is located in the neck and surrounded by large blood vessels, trachea, esophagus and nerves, it is safer to perform puncture biopsy of thyroid nodules/occupations under ultrasound monitoring.
Treatment.
Surgery is recommended for malignant nodules found especially if they are large and have lymph node metastases. Benign nodules may be treated with ultrasound-guided minimally invasive ablation, depending on the circumstances, or with regular observation until they progress to surgical indications. Early stage papillary thyroid cancer can also be treated by ultrasound minimally invasive ablation.
Compared with surgery, ultrasound-guided radiofrequency/microwave minimally invasive ablation for in situ inactivation of thyroid nodules has the following advantages.
1. Since the treatment is ultra-minimally invasive, patients can return home after 30-40 minutes of observation without discomfort, so there is no need for hospitalization.
2, and preoperative only need to check the coagulation, liver disease and HIV protozoology, compared with inpatient treatment to reduce many unnecessary examination costs and bed space.
3.It is difficult to perform surgery after recurrence in patients who have been operated before. For these patients and patients with recurrence of postoperative cervical lymph node metastasis, ultra-minimally invasive surgery provides a very good solution for this group of patients.
The advantages of ultrasound-guided radiofrequency/microwave minimally invasive ablation of thyroid nodules in situ are
1.Ultra-minimally invasive treatment with little patient injury, adding an ultra-minimally invasive treatment modality to the treatment of benign thyroid nodules.
2. Avoiding skin scarring on exposed parts of the neck due to open surgery: Traditional thyroid surgery leaves obvious scarring at the patient’s skin incision, which affects the aesthetic psychology of patients, especially women. Reducing or avoiding scarring is in line with the need for psychological minimally invasive surgery.
3.Provide retreatment for patients with recurrence of benign thyroid nodules after excision. Benign thyroid nodules are often multiple and prone to recurrence after surgery, and the adhesions, scarring, and obvious disorder of anatomical structure caused by the first surgery make it difficult to perform the surgery repeatedly and increase the complications significantly. This method can effectively overcome these shortcomings.
4.Provide viable treatment for microscopic thyroid nodules. Advances in high-frequency ultrasound technology have enabled the detection of more and more microscopic thyroid nodules (millimeter level) that are difficult to palpate clinically. The difficulty in palpation of microscopic thyroid nodules puts pressure on the localization of the lesion during surgery, and surgeons often forgo surgical treatment.
After surgical resection of thyroid cancer, recurrent cancer foci may appear in the residual gland or in the lymph nodes adjacent to the large blood vessels in the neck, and surgical resection again or even three times is not only more difficult and more traumatic, but also often resisted by patients. Moreover, surgical resection cannot prevent the recurrence of cancer foci at all. Local in-situ inactivation with alternative effect and repeated implementation is the most reliable treatment, including microwave and radiofrequency thermal ablation.