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Purpose <p>Ultrasound (US)-guided thermal ablation (TA) is widely used as a minimally invasive alternative to surgery for symptomatic benign thyroid nodules. Although less invasive, complications occur in up to 4% of cases. This review assessed the incidence of TA-related complications, focusing on prevention and management.</p> Material and methods <p>PubMed, Embase, and Cochrane were searched for studies on thyroid TA complications. Eligible studies were in English, included &gt; 100 patients, reported complication rates, and had full text available. Studies with malignant nodules, unclear reporting, or &lt; 100 patients were excluded. Risk of bias was assessed with ROBINS-I and evidence certainty with GRADE. Complications and preventive strategies were summarized.</p> Results <p>Among 282 screened studies, 11 including 15,333 patients were analyzed. The pooled overall complication rate was 4.3% (range 1.0–8.8%). Post-procedural pain was most common (1.5%, range 0–5%). Major complications were rare (0.16%), while minor complications occurred in 4.2%. Prevention relied on operator training, knowledge of neck anatomy, hydrodissection, trans-isthmic approach, and moving-shot technique.</p> Conclusions <p>Thyroid TA is safe, with very low major complication rates, though minor events may occur. Best results require strong anatomical knowledge, ultrasound expertise, and correct technique. Evidence quality remains low with moderate-to-serious risk of bias.</p>

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Complications of minimally invasive treatments of benign thyroid nodules: preventive andmanaging strategies: A systematic review

  • 期刊论文

  • 发表日期：

    2026年5月29日

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  • Giovanni Mauri,
  • Lorenzo Monfardini,
  • Pierluigi Glielmo,
  • Antonio Galluzzo,
  • Pierre Yves Marcy,
  • Robert M. Eisele,
  • Michael Douek,
  • Auh Whan Park,
  • Wei-Che Lin,
  • Edouard Ghanassia,
  • Gilles Russ,
  • Daniele Maiettini,
  • Juan Pablo Dueñas,
  • Stefano Spiezia,
  • Giovanni Antonelli,
  • Enrico Papini,
  • Luigi Solbiati,
  • Luca Maria Sconfienza

摘要

Purpose

Ultrasound (US)-guided thermal ablation (TA) is widely used as a minimally invasive alternative to surgery for symptomatic benign thyroid nodules. Although less invasive, complications occur in up to 4% of cases. This review assessed the incidence of TA-related complications, focusing on prevention and management.

Material and methods

PubMed, Embase, and Cochrane were searched for studies on thyroid TA complications. Eligible studies were in English, included > 100 patients, reported complication rates, and had full text available. Studies with malignant nodules, unclear reporting, or < 100 patients were excluded. Risk of bias was assessed with ROBINS-I and evidence certainty with GRADE. Complications and preventive strategies were summarized.

Results

Among 282 screened studies, 11 including 15,333 patients were analyzed. The pooled overall complication rate was 4.3% (range 1.0–8.8%). Post-procedural pain was most common (1.5%, range 0–5%). Major complications were rare (0.16%), while minor complications occurred in 4.2%. Prevention relied on operator training, knowledge of neck anatomy, hydrodissection, trans-isthmic approach, and moving-shot technique.

Conclusions

Thyroid TA is safe, with very low major complication rates, though minor events may occur. Best results require strong anatomical knowledge, ultrasound expertise, and correct technique. Evidence quality remains low with moderate-to-serious risk of bias.