Lever-elevating vs. liquid-isolating maneuvers during microwave ablation of high-risk benign thyroid nodules: a prospective single-center study

Figures & data

Figure 1. A flow-chart of the study design.

Figure 2. Dangerous thyroid triangle.

Figure 3. Two types of lever-elevating maneuvers were performed, as determined by the site to be used for insertion of the microwave needle. With one approach, the needle was inserted into a lateral region of the neck (a). With the trans-isthmic approach, the needle is inserted along the neck midline (b).

Figure 4. (a) Liquid-isolating zone between the thyroid and the common carotid artery. (b) Liquid-isolating zone between the thyroid and trachea (↓, hyperechoic zone after ablation; *, liquid-isolating zone; TH, thyroid; T, trachea; CCA, common carotid artery).

Figure 5. (a) Insertion of the microwave needle into the thyroid gland lesion; (b) Elevation of the microwave needle to separate the thyroid lesion from the dangerous triangle (↓, electrode needle; △: dangerous triangle; TH, thyroid; T, trachea; CCA, common carotid artery).

Table 1. Patient characteristics.

Characteristic		Group		t/χ^2	p Value
		LIM (n = 87)	LEM (n = 87)
Age (year)		44.5 ± 10.8	42.3 ± 11.6	t = 0.628	.481
Sex (n)	male	35	39	χ^2 = 0.376	.540
	female	52	48
Nodule diameter (cm, X ± S)		2.52 ± 1.38	2.46 ± 1.07	t = 1.127	.264
No. of Nodules (X ± S)		3.4 ± 0.8	3.2 ± 0.5	t = 1.492	.157
Pathological type	nodular goiter	83	85	–	.682^a
	thyroid adenoma	4	2

^aFisher test.

Table 2. Operative time and complications in both study groups.

Characteristic	Group		t/x^2	p Value
	LIM	LEM
Operative time (min)	44.75 ± 13.14	32.87 ± 10.84	t = 2.509	.017
Voice change N (%)	6 (6.9)	2 (2.3)	--	.278^a
Time to recovery (days)	36.15 ± 10.24	24.48 ± 11.53	t = 2.615	.014
Cervical Compression N (%)	9 (10.3)	2 (2.3)	.x^2=4.755	.029
Hematoma N (%)	10 (11.5)	3 (3.4)	x^2=4.047	.044
Vasovagal reactions N (%)	0	1 (1.1)	–	1.000^a

^aFisher test.

Data availability statement

The datasets generated and analyzed during the present study are available from the corresponding author on reasonable request.