Surgical Versus Non Surgical Management of Thyroid Nodule
Surgical Versus Non Surgical Management of Thyroid Nodule
To compare between surgical (hemi thyroidectomy and total thyroidectomy) and non-surgical
 (medical, ethanol injection,thermal ablation and laser photo coagulation) management of
 simple thyroid nodule regarding:

 -  Outcome of every type of management

 -  Feasibility of minimally invasive technique in management of simple thyroid nodule in
 Asyut university

 -  Complication of every type of management
Thyroid nodules are very common in clinical practice; they are discovered by palpation in
 3-7% and by ultrasound (US) in about 50% of the general population. The majority of thyroid
 nodules are benign and asymptomatic. The main management of benign thyroid nodules is
 observation and follow-up; however, a minority of them (10-15%) increase in size over time
 and may induce symptoms or cosmetic issues. Surgical excision has been established as a
 treatment for symptomatic benign thyroid nodules. thyroidectomy for benign thyroid disease
 continues to remain controversial, as there are many conflicting data published in the
 literature regarding the risk of hypothyroidism and recurrent laryngeal nerve injury
 stratified to indications for surgery, extent of thyroid resection and surgical volume .It
 carries a 2-10% risk of complications and neck scarring .Thyroid surgery is also costly and
 may not be appropriate for patients who have a high risk of surgical morbidity.Therefore,
 image-guided nonsurgical procedures such as ethanol ablation (EA) and thermal ablation have
 been proposed as alternative and less invasive approaches for the management of benign
 symptomatic thyroid nodules .These so-called thermoablative methods induce local
 thermodestruction, leading to nodule shrinkage and improvement of local symptoms. Monopolar
 radiofrequency ablation (RFA) and EA is widely used as a nonsurgical treatment usually for
 cystic (i.e., pure cyst) or predominantly cystic benign thyroid nodules (i.e., cystic portion
 > 50%). There is another method called US-guided percutaneous laser ablation (PLA) is a safe
 and effective therapeutic option as an alternative to surgery for benign symptomatic nodules
Inclusion Criteria:

 -  complicated thyroid nodule

 Exclusion Criteria:

 -  less than 18 malignant thyroid nodule