polidocanol and Thyroid-Diseases

To evaluate the clinical efficacy of ultrasound-guided lauromacrogol sclerotherapy for benign thyroid cysts and analyze the factors affecting the efficacy.. Ultrasound-guided lauromacrogol sclerotherapy was performed in 97 patients with a total of 99 benign thyroid cysts. The changes in cystic volume and other thyroid parameters were evaluated at 1, 3, 6, and 12 months after sclerotherapy. According to changes in the cystic volume, the efficacy of sclerotherapy was defined as therapeutic failure (with a volume reduction <50%), treatment success (volume reduction ≥50%) and cure (volume reduction ≥90%). The factors of affecting the efficacy of sclerotherapy was analyzed using COX regression.. Ultrasound-guided lauromacrogol sclerotherapy is effective and safe for treatment of benign thyroid cysts, and the maximal treatment effect can be achieved at 6 months after sclerotherapy and in cases of uncomplicated cysts with non-viscous cystic fluid, no solid cystic cavity separation and a disease course of less than 12 months.

Topics: Adenoma, Oxyphilic; Cell Wall; Cysts; Disease Progression; Ethanol; Humans; Injections, Intralesional; Polidocanol; Polyethylene Glycols; Precancerous Conditions; Risk Factors; Sclerotherapy; Thyroid Diseases; Thyroid Gland; Treatment Outcome; Ultrasonography

Topics: Adult; Cysts; Female; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Thyroid Diseases

In a study extending over a period of 4 years, therapeutic fine-needle aspirations were carried out in 194 thyroid patients with thyroid cysts. The cyst contents of 3-130 ml cyst fluid were completely removed by suction in 2-3 month intervals by 1-17 fine-needle aspirations on an outpatient basis. Malignancy was ruled out in all patients by repeated cytological tests. Complete emptying of the cyst, verified by twice-repeated check at 3-month intervals, was achieved in 86 patients (44.3%). A reduction of the cyst fluid to less than 30% was achieved in 13 patients (6.7%). In 17 patients (8.8%) the cyst fluid diminished to 31-50%. In 44 patients (22.7%) there was no diminution in the cyst fluid or a reduction of less than 50%. There was an increase in cyst fluid compared with the first puncture in 34 patients (17.5%). The success of puncture cannot be predicted, although cysts with brown cyst fluids can be emptied significantly more frequently than cysts with yellow cyst fluids (63% as compared with 43.5%, p less than 0.005). Cyst fluid volume, T3- and T4-contents of the cyst fluid, age and sex had no influence on therapeutic effect. Up to the 5th puncture the prospects of success are approximately constant, but even in cases of more frequent punctures emptying still takes place. Thyroid hormone therapy with 50-100 micrograms 1-T4 daily (n = 134), and a single intracystic injection of 40 mg methylprednisolone-crystal suspension (n = 42) or of 0.02 g hydroxypolyaethoxydodecan 1% (n = 11) did not show better results than the single aspiration. There were no complications except for 2 cases of afterbleeding in the cysts immediately after puncture, and these were easily dealt with. Fine-needle aspiration is a simple, effective and cost-saving method for the elimination of the frequent cosmetically disturbing thyroid cysts in half of patients, thus avoiding surgery.

Topics: Cysts; Female; Humans; Male; Methylprednisolone; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Suction; Thyroid Diseases