SAT457 Ethanol Ablation For The Treatment Of Cystic Thyroid Nodules: The First Ecuadorian Prospective Cohort

Abstract

Abstract Disclosure: A.P. Solis Pazmiño: None. F. Carrion: None. J. Mesias: None. E. Pilatuna: None. R. Godoy: None. C. Garcia: None. Introduction: Percutaneous ethanol injection (PEI) has been adopted to treat benign cystic nodules in the last decade. For this study, we aimed to investigate the change in nodule volumes and cosmetic scores before and after EA in benign thyroid nodules and the effectiveness of treatment. Method: This prospective study, conducted at ITECC, included adults who underwent PEI for benign thyroid nodules (TN) with cystic content, between February 2021 and October 2022. The technique first consists of providing anesthesia using 10 ml of 2% solution. lidocaine. We then injected 75% ethanol into 1/3 of the volume of the TN. Nodule size and volume, thyroid function, and complications were evaluated before and after UPEA. Initial volume and change in TN volume were calculated with the ATA calculator and the independent-samples T-test. Results: A total of 13 patients with purely cystic single nodules with non-functioning and graded as Bethesda II were included. The mean age at the time of PEI was 52.46 years, and most of the patients were female (76.9%), euthyroid (77%), and symptomatic (69%). The median largest diameter of the thyroid cyst was 4.0 cm (interquartile range [IQR], 3.2 -4.5 cm; range, 1.7-5.9 cm); the median volume pre-PEI was 15.06 mL (IQR, 3.63-22.07 mL; range, 0.6-44.8 mL). The median amount of cystic fluid drained before PEI was 20 mL, and the median amount of ethanol administered was 3,85 mL (IQR, 3-5.25 mL; range, 1.5-6 mL). After a month’s follow-up, of 10 patients with available imaging on follow-up, 8 (80%) had a 50% or greater reduction in nodule volume. The median volume post-PEI was 1.5 (IQR, 0.6-8.1) ml decrease, 80.44% [IQR, 31.88%-95%]). We did not have any adverse effects. Prior to ablation, there were 46% of patients with cosmetic problems and symptomatic scores. At the 12-month follow-up, the overall cosmetic score improved from 2 to 0 (p< 0.001), as well as the overall symptomatic score improved from 3.2 to 0.5. Conclusions: Percutaneous ethanol injection seems to be a safe and effective alternative to surgical resection for patients with purely or predominantly cystic thyroid nodules and compressive symptoms who decline surgery or are not good surgical candidates. ITECC is the first center in Ecuador to perform this procedure, having encouraging results with a considerable reduction in TN in the first month with symptomatic relief and improvement in cosmetic score. Presentation: Saturday, June 17, 2023