Thyroid nodule ablation, not all patients are suitable for it: Thyroid nodule ablation treatment, due to its highly minimally invasive nature, as well as its fast recovery and few complications, is being carried out in more and more hospitals and is becoming the preferred treatment option for more and more patients. As the most experienced team of thyroid nodule ablation in Northwest China, Dr. Shuang Jianbo’s team has concluded two particular points that need to be paid attention to. If these two issues are not handled properly, patients will be unhappy and doctors will be in trouble! One is which thyroid nodules really need to be done! The second is that the nodules are still there on review after they are done! One is which thyroid nodules really need to be done: We have encountered in the clinic, and seen in consultations around the world, that there are often many that do not need to be done, and the local doctors recommend ablation. Thyroid nodules are very common, and I often say that if you catch 10 people on the road, at least 2 of them have thyroid nodules. If such a large percentage of the population needs it, then the hospital should not do anything else, that is over-medication. Which ones need to be done? Which ones don’t need to be treated at all? Which ones need to be reviewed regularly? What needs further examination? These are not questions that can be solved with a casual Baidu. Nor can doctors in certain specialty hospitals scare patients when they see a nodule: this needs to be treated or there will be serious consequences! For patients, two suggestions: for the general population, one is to go to a large hospital for specialist consultation; for the more advanced patients, the second is to go deeper into Baidu and find “guidelines” or “expert consensus” documents to look at, and if you are strong in English, you can also If you have good English skills, you can also pubmed professional literature. I listed the “Expert Consensus on Thermal Ablation of Benign Thyroid Nodules, Microscopic Carcinoma and Metastatic Lymph Nodes in the Neck (2018 Edition)”, which states that thyroid ablation should only be considered in the following cases: benign nodule indications Those who meet 1 to 3 of the indications and 4 of the indications. Ultrasound suggestive of benign, fine needle aspiration biopsy cytologic pathology reported as class II by the FNA-Bethesda reporting system, or preoperative histologic biopsy pathology confirming a benign nodule; patient has no history of childhood radiation therapy; patient has a well-informed request for minimally invasive intervention, or refusal of surgical procedure and clinical observation; one of the following conditions is also met: (1) autonomous functional nodule causing hyperthyroid symptoms (2) Patients with conscious symptoms (e.g. foreign body sensation, neck discomfort or pain, etc.) clearly associated with the nodule or affecting the aesthetics and requesting treatment; (3) residual recurrent nodules after surgery, or nodules of significantly larger size. Indications for papillary thyroid carcinoma: The following 9 items need to be satisfied simultaneously Non-pathologic high-risk subtype; tumor diameter ≤5mm (relaxed to ≤1cm for tumors not immediately surrounding the envelope) and nodules >2mm from the medial posterior envelope; no invasion of the thyroid peritoneum and no surrounding tissue invasion; cancer not located in the isthmus; no family history of thyroid cancer; no history of radiation exposure to the neck during adolescence or childhood; no evidence of lymph nodes or distant metastases; patients who have been adequately informed by medical staff. who refused surgery and close follow-up even after being fully informed by medical staff. The second is that the nodules are still there after the ablation: the patient is happy to go home after the ablation, but a month later, the doctor tells him that the nodules are still there, the patient will definitely explode on the spot. Therefore, the doctor who does thyroid ablation must tell the patient the knowledge and the principle of thermal ablation thoroughly, in a language that is easy to understand, in a language that a 3 year old can understand. This is what I said for your reference: ablation means to burn the nodules to death and bake them like meat. Ablation is not the same as open surgery. Open surgery is to cut down the lesion and take it out; ablation cooks the nodule and leaves it in the body without taking it out. The nodule turns from a living cell to a dead cell and remains in the body to be slowly absorbed. But not everyone’s nodules are completely absorbed. According to our data and literature, after one year of ablation, the nodules shrink to about 50% of their previous size. Therefore, when you review, some doctors do not understand the technique of ablation and may say that there are still nodules in the thyroid. He doesn’t understand, you need to understand that this is the original nodule that was left in the body after it was burned.