Surgeon-Performed Ultrasound-Guided Microwave Ablation for Benign Thyroid Nodules: A Single-Surgeon Clinical Experience

BACKGROUND: Benign thyroid nodules are common and may cause compressive symptoms, cosmetic concerns, or hyperthyroidism. Ultrasound (US)-guided thermal ablation has emerged as a minimally invasive alternative to surgery. This study aimed to evaluate the efficacy and safety of surgeon-performed US-guided microwave ablation (MWA) for benign thyroid nodules. METHODS: A retrospective analysis of prospectively collected data was performed on 32 patients who underwent US-guided MWA between May 2023 and May 2024. All procedures were performed by a single surgeon. Nodule volume, volume reduction ratio (VRR), thyroid function tests, and complications were evaluated at baseline and at 6- and 12-month follow-up. Technical success was defined as VRR >50% at 12 months. RESULTS: The mean baseline nodule volume was 17.73±11.70 cm3, which decreased significantly to 7.40±4.92 cm3 at 6 months and to 2.31±1.61 cm3 at 12 months (P<0.001). Mean VRR was 58.5% at 6 months and 87.1% at 12 months, with technical success achieved in all patients. VRR was not significantly affected by nodule composition, size, vascularity, or location. Among 3 patients with toxic adenoma, euthyroidism was achieved in 2 patients with complete discontinuation of antithyroid medications, while 1 patient improved from overt to subclinical hyperthyroidism with reduced medication dosage. No major complications were observed. CONCLUSIONS: Surgeon-performed US-guided MWA is a safe and highly effective minimally invasive treatment for benign thyroid nodules, providing substantial and durable volume reduction with excellent clinical outcomes in appropriately selected patients.