Observation on safety and effectiveness of modified hydrodissection fluid in microwave ablation of benign thyroid nodules

doi:10.16139/j.1007-9610.2025.04.09

Abstract

Abstract:

Objective To investigate the safety and effectiveness of normal saline as a hydrodissection band versus sodium hyaluronate and biopolysaccharide mixture as a modified hydrodissection band in microwave ablation (MWA) for benign thyroid nodules. Methods A total of 196 patients with 245 benign thyroid nodules(maximum diameter ≥20 mm) treated at Shanghai Ruijin Rehabilitation Hospital from August 2018 to February 2022 were enrolled. Patients were divided into control group (n=114): MWA using normal saline as the hydrodissection fluid; modified group (n=131): MWA using sodium hyaluronate and biopolysaccharide mixture as the hydrodissection fluid. A hydrodissection band (about 10 mm wide) was established before MWA. Intraoperative hydrodissection fluid absorption time was recorded. At the 12-month follow-up endpoint, complications were assessed, and changes in nodule volume (volume reduction rate, VRR) were evaluated. Results The complication rate was significantly lower in the modified group (1.9% vs.14.0%, P<0.05). 92.3% of complications in the control group were thermal injury-related, while no thermal injuries occurred in the modified group. Hydrodissection fluid absorption time was significantly prolonged in the modified group [(15.2±1.6) min vs. (11.0±2.3) min, P<0.05].No significant difference was observed in overall treatment efficacy (nodule VVR) between two groups (95.4% vs. 96.5%, P>0.05). Conclusions The sodium hyaluronate and biopolysaccharide mixture demonstrates prolonged retention time and superior thermal insulation as an hydrodissection fluid in MWA. It reduces adhesion risks and complications such as hoarseness, dysphagia, and thermal injury, thereby enhancing procedural safety and postoperative recovery. MWA is an effective treatment for benign thyroid nodules.

Key words: Benign thyroid nodule, Microwave ablation(MWA), Modified hydrodissection fluid, Complication, Sodium hyaluronate and biopolysaccharide mixture

CLC Number:

R653

HUANG Li, ZHAO Yanna, GU Jianhua, XU Wenjuan, LIU Jun, FEI Jian. Observation on safety and effectiveness of modified hydrodissection fluid in microwave ablation of benign thyroid nodules[J]. Journal of Surgery Concepts & Practice, 2025, 30(04): 345-350.

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Item	Modified group （n=103）	Control group (n=93)	t value	P value
Age(year)	46.3±13.9	49.0±15.0	0.953	0.200
Male∶Female	26（25.2）∶77（74.8）	18（19.4）∶75（80.6）	/	0.392
Nodule preoperative volume（mL）	20.3±10.4	20.0±11.5	1.069	0.240

Complications	Modified group（n=103）	Control group（n=93）	χ² value	P value
Neck discomfort, dysphagia	0	0
Hoarseness, loss of voice	0	9（9.7）
Horner syndrome	0	1（1.1）
Scald	0	2（2.2）
Nodular rupture	2（2.2）	1（1.1）
Total incidence	2（1.9）	13（14.0）	10.022	0.002

Item	Modified group	Control group	t value	P value
Number of nodules	131	114
Absorption time (min)	15.2±1.6	11.0±2.3	17.992	0.000

VRR	Modified group （n=131）	Control group (n=114)	χ² value	P value
<50％	6（4.6）	4（4.5）
50％~90％	38（29.0）	32（28.1）
>90％	87（66.4）	78（68.4）
≥50%	125（95.4）	110（96.5）	0.179	0.672