Overview of the treatment of thyroid nodules

  Thyroid nodules are a common clinical condition, and with the use of high-resolution ultrasound, the detection rate of thyroid nodules has reached 20-76% of the population, and the detection rate of thyroid cancer in nodules has reached 5-15%, with up to 60,220 new thyroid cancer cases in the United States in 2013
, the 2014 Beijing Health White Paper revealed a nearly 400% increase in thyroid cancer over 10 years and a significant increase in the rate of surgery for non-essential thyroid nodules (ATA and Chinese guidelines for the diagnosis and treatment of thyroid nodules and differentiated thyroid cancer). In order to meet the medical needs of patients with minimally invasive or non-invasive treatments, various minimally invasive treatments have emerged: (1) Total endoscopic excision (TET): it only satisfies the cosmetic effect of the neck, but the trauma to the organism is not less than or even greater than that of open excision.  (2) Ethanol injection sclerotherapy: repeated treatment is required for several times, and the efficacy of solid nodules is poor.  (3) Ultrasound-guided percutaneous thermal ablation therapy: radiofrequency, microwave, laser ablation, etc. The core connotation of thermal ablation therapy is to completely inactivate the lesion in situ by using thermal effect, i.e. tumor cells coagulation and necrosis, microcirculation destruction, lesion gradually shrinking or even disappearing. Compared with open surgery, it has the characteristics of short operation time, no pain during and after operation, minimal trauma, more stable postoperative process, more accurate efficacy, obvious cosmetic effect, and no damage to thyroid function. It has been applied to thyroid adenoma, nodular goiter, postoperative recurrent nodular goiter, microscopic thyroid cancer, postoperative recurrent thyroid cancer, lymph node metastasis cancer and parathyroid adenoma.