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Background <p>Image-guided ablation techniques have emerged as minimally invasive alternatives to surgery for selected thyroid nodules. While international guidelines support their use in defined settings, variability in disease presentation, diagnostic standards, operator expertise, and follow-up infrastructure limits direct applicability to Indian practice.</p> Methods <p>The Indian Association of Endocrine Surgeons (IAES) developed national guidelines using the GRADE-ADOLOPMENT framework (adoption, adaptation, and de novo development). International guidelines and key evidence were reviewed, and draft statements were formulated addressing indications, pre-procedure assessment, procedural safety, follow-up, complication reporting, training, and implementation. A multidisciplinary expert panel undertook a two-round modified Delphi consensus process. Consensus was predefined as ≥ 75% agreement (scores 7–9 on a 9-point Likert scale).</p> Results <p>Eighteen experts completed both Delphi rounds (100% response rate). Of 26 statements evaluated, 21 (80.8%) achieved consensus in Round 1. After revision, 4 of 5 remaining statements reached consensus in Round 2. Final recommendations included adopted, adapted, and de novo statements, with conditional and research-only recommendations where evidence or feasibility was limited. Key areas of emphasis included stringent patient selection, diagnostic reliability, operator credentialing, real-time voice monitoring, standardized follow-up, and complication reporting.</p> Conclusions <p>These IAES guidelines provide the first Indian, context-specific framework for the safe adoption of thyroid ablation techniques. By integrating international evidence with local feasibility and safety considerations, they aim to support responsible implementation while minimizing preventable harm. Ongoing audit and prospective research are essential to refine these recommendations as experience evolves.</p>

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Guidelines for the safe performance, training, and adoption of ablation techniques for benign thyroid nodules: An Indian Association of endocrine surgeons consensus statement

  • 期刊论文

  • 发表日期：

    2026年5月22日

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  • Sanjay Kumar Yadav,
  • Siddhartha Chakravarthy,
  • Sanjeet Kumar,
  • Abhishek Krishna,
  • Anjali Mishra,
  • Anukriti Sood,
  • Aromal Chekavar Suresh,
  • Balaji srinivasan,
  • Devashish Mishra,
  • Manjunath Goroshi,
  • Nishtha Yadav,
  • Ritesh Agrawal,
  • Sabaretnam M,
  • Sarrah Idrees,
  • Shikhil Puzhakkal,
  • Smitha S. Rao,
  • Sunil Malla Bujar Barua,
  • Vikram Singh Chauhan,
  • Yuvraj Devgan

摘要

Background

Image-guided ablation techniques have emerged as minimally invasive alternatives to surgery for selected thyroid nodules. While international guidelines support their use in defined settings, variability in disease presentation, diagnostic standards, operator expertise, and follow-up infrastructure limits direct applicability to Indian practice.

Methods

The Indian Association of Endocrine Surgeons (IAES) developed national guidelines using the GRADE-ADOLOPMENT framework (adoption, adaptation, and de novo development). International guidelines and key evidence were reviewed, and draft statements were formulated addressing indications, pre-procedure assessment, procedural safety, follow-up, complication reporting, training, and implementation. A multidisciplinary expert panel undertook a two-round modified Delphi consensus process. Consensus was predefined as ≥ 75% agreement (scores 7–9 on a 9-point Likert scale).

Results

Eighteen experts completed both Delphi rounds (100% response rate). Of 26 statements evaluated, 21 (80.8%) achieved consensus in Round 1. After revision, 4 of 5 remaining statements reached consensus in Round 2. Final recommendations included adopted, adapted, and de novo statements, with conditional and research-only recommendations where evidence or feasibility was limited. Key areas of emphasis included stringent patient selection, diagnostic reliability, operator credentialing, real-time voice monitoring, standardized follow-up, and complication reporting.

Conclusions

These IAES guidelines provide the first Indian, context-specific framework for the safe adoption of thyroid ablation techniques. By integrating international evidence with local feasibility and safety considerations, they aim to support responsible implementation while minimizing preventable harm. Ongoing audit and prospective research are essential to refine these recommendations as experience evolves.