Outcome, Pain Perception, and Health-Related Quality of Life in Patients Submitted to Percutaneous Ethanol Injection for Simple Thyroid Cysts

Journal of Thyroid Research, Jul 2017

Thyroid cysts are usually benign lesions that when voluminous may induce cosmetic concerns or local discomfort. Percutaneous ethanol injection (PEI) has been demonstrated to be effective for shrinkage of such cysts. In this retrospective study, we evaluated the efficacy, pain perception, and health-related quality of life (HRQL) in patients submitted to PEI for pure cystic lesions. We reviewed the data of 101 patients who underwent ≤3 PEI. In the whole group of patients, the volume reduction was 66% after the first, 74.4% after the second, and 79.4% after the third PEI treatment. 55.4% had a cystic volume ≤ 10 ml; 85.7% of cysts ≤ 10 ml were cured by just one PEI. The number of PEI was significantly higher in the >30.0 ml group; this latter group obtained the smallest percent reduction versus baseline after the first PEI when compared with smaller cysts. The sensation of pain reported during PEI was absent in 78.3% of cases, and HRQL significantly improved from pre- to the posttreatment. PEI is a safe and effective technique for pure cystic lesions. In addition, HRQL significantly improves, providing a further support for this procedure.

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Outcome, Pain Perception, and Health-Related Quality of Life in Patients Submitted to Percutaneous Ethanol Injection for Simple Thyroid Cysts

Outcome, Pain Perception, and Health-Related Quality of Life in Patients Submitted to Percutaneous Ethanol Injection for Simple Thyroid Cysts Roberto Negro,1 Ermenegildo Colosimo,2 and Gabriele Greco1 1Division of Endocrinology, “V. Fazzi” Hospital, Piazza F. Muratore, 73100 Lecce, Italy 2Division of Pathology, “V. Fazzi” Hospital, Piazza F. Muratore, 73100 Lecce, Italy Correspondence should be addressed to Roberto Negro; Received 29 April 2017; Accepted 29 May 2017; Published 9 July 2017 Academic Editor: Massimo Tonacchera Copyright © 2017 Roberto Negro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Thyroid cysts are usually benign lesions that when voluminous may induce cosmetic concerns or local discomfort. Percutaneous ethanol injection (PEI) has been demonstrated to be effective for shrinkage of such cysts. In this retrospective study, we evaluated the efficacy, pain perception, and health-related quality of life (HRQL) in patients submitted to PEI for pure cystic lesions. We reviewed the data of 101 patients who underwent ≤3 PEI. In the whole group of patients, the volume reduction was 66% after the first, 74.4% after the second, and 79.4% after the third PEI treatment. 55.4% had a cystic volume ≤ 10 ml; 85.7% of cysts ≤ 10 ml were cured by just one PEI. The number of PEI was significantly higher in the >30.0 ml group; this latter group obtained the smallest percent reduction versus baseline after the first PEI when compared with smaller cysts. The sensation of pain reported during PEI was absent in 78.3% of cases, and HRQL significantly improved from pre- to the posttreatment. PEI is a safe and effective technique for pure cystic lesions. In addition, HRQL significantly improves, providing a further support for this procedure. 1. Introduction Thyroid cysts, that is, a thyroid lesion having a delimiting wall with a fluid content, are more rare than thyroid nodules but may induce cosmetic concerns and compressive symptoms as well. They are benign by definition, and after the advent of percutaneous ethanol injection (PEI), in most cases they do not require surgical treatment. Indeed, it is more than 20 years that PEI is successfully used as a safe, cheap, and effective treatment to significantly and permanently reduce the cystic volume, with a consequent relief for the patient [1–3]. Whereas data about efficacy of PEI are consistent, data about health-related quality of life (HRQL) are virtually absent. In this report, we retrospectively evaluated the outcome, the pain perception, and the HRQL of a hundred of patients suffering from pure thyroid cysts who were submitted to PEI at our Institution. 2. Methods We reviewed the data of patients treated in our Institution from 2012 to 2016. Criteria of inclusion were euthyroid patients who underwent PEI for a simple cystic lesion and having complaints for aesthetic or compressive troubles, negative cytologic result, and any cystic volume, but a number of PEI ≤ 3. Cystic volume was calculated using the ellipsoid formula (<glyph.data ascent="3473" descent="-2876" horiz-adv-x="766" vert-adv-y="766" xpluscharwidth="9.958"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" xpluscharwidth="16.198"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" xpluscharwidth="26.735"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="766" vert-adv-y="766" xpluscharwidth="39.598"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" xpluscharwidth="45.838"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" xpluscharwidth="56.375"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="766" vert-adv-y="766" xpluscharwidth="69.238"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" xpluscharwidth="75.479"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587" xpluscharwidth="86.015"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" xpluscharwidth="95.161"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="228" vert-adv-y="228" xpluscharwidth="98.125"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" xpluscharwidth="104.365"></glyph.data><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480" xpluscharwidth="110.60499999999999"></glyph.data>). 2.1. PEI Procedure After disinfection of the skin and the use of anesthetic sprayed locally, using sonographic guidance, a 20-22-gauge needle is inserted into the cyst; after drainage of the almost total amount of cystic fluid, absolute ethanol is instilled to spread within the cyst. T (...truncated)


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Roberto Negro, Ermenegildo Colosimo, Gabriele Greco. Outcome, Pain Perception, and Health-Related Quality of Life in Patients Submitted to Percutaneous Ethanol Injection for Simple Thyroid Cysts, Journal of Thyroid Research, 2017, 2017, DOI: 10.1155/2017/9536479