{"id":9487,"date":"2024-05-29T12:07:28","date_gmt":"2024-05-29T09:07:28","guid":{"rendered":"https:\/\/ozgurkilickesmez.com\/?p=9487"},"modified":"2025-09-04T20:55:17","modified_gmt":"2025-09-04T17:55:17","slug":"ablatia-nodulilor-tiroidieni","status":"publish","type":"post","link":"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/","title":{"rendered":"Abla\u021bia nodulilor tiroidieni"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Ablatia nodulilor tiroidieni este o procedur\u0103 minim invaziv\u0103 destinat\u0103 trat\u0103rii forma\u021biunilor benigne sau suspecte, f\u0103r\u0103 necesitatea interven\u021biei chirurgicale clasice. Aceasta utilizeaz\u0103 c\u0103ldura sau energia pentru distrugerea \u021besutului patologic.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Metodele moderne de abla\u021bie includ radiofrecven\u021ba, laserul \u0219i microundele, toate realizate sub ghidaj ecografic. Acestea reduc dimensiunea nodulului \u0219i amelioreaz\u0103 simptomele compresive.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Recuperarea dup\u0103 abla\u021bia tiroidian\u0103 este rapid\u0103, pacientul fiind externat \u00een aceea\u0219i zi. Riscurile sunt minime, iar func\u021bia glandei se p\u0103streaz\u0103 intact\u0103.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Indica\u021biile pentru aceast\u0103 procedur\u0103 vizeaz\u0103 pacien\u021bii cu noduli tiroidieni benigni simptomatici sau cu suspiciuni oncologice minore. Abla\u021bia reprezint\u0103 o solu\u021bie sigur\u0103, eficient\u0103 \u0219i estetic\u0103.<\/span><\/p>\n<p><span data-sheets-root=\"1\">\n\t<section class=\"section\" id=\"section_494268135\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t\t\t\t\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n\n<div class=\"row\"  id=\"row-196604684\">\n\n\n\t<div id=\"col-471121692\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\" style=\"background-color:#1c58ef;\" >\n\t\t\t\n\t\t\t\n\n<div class=\"row\"  id=\"row-100360386\">\n\n\n\t<div id=\"col-1127625473\" class=\"col medium-4 small-12 large-4\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n\t<div class=\"img has-hover border-gorsel x md-x lg-x y md-y lg-y\" id=\"image_359430967\">\n\t\t\t\t\t\t\t\t<div class=\"img-inner dark\" >\n\t\t\t<img decoding=\"async\" width=\"1020\" height=\"1020\" src=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2025\/08\/Medic-specialist-in-Radiologie-Interventionala-si-Neuroradiologie-1024x1024.webp\" class=\"attachment-large size-large\" alt=\"Medic specialist \u00een Radiologie Interven\u021bional\u0103 \u0219i Neuroradiologie\" srcset=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2025\/08\/Medic-specialist-in-Radiologie-Interventionala-si-Neuroradiologie-1024x1024.webp 1024w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2025\/08\/Medic-specialist-in-Radiologie-Interventionala-si-Neuroradiologie-300x300.webp 300w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2025\/08\/Medic-specialist-in-Radiologie-Interventionala-si-Neuroradiologie-150x150.webp 150w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2025\/08\/Medic-specialist-in-Radiologie-Interventionala-si-Neuroradiologie.webp 1080w\" sizes=\"(max-width: 1020px) 100vw, 1020px\" title=\"\">\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\n<style>\n#image_359430967 {\n  width: 100%;\n}\n<\/style>\n\t<\/div>\n\t\n\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1127625473 > .col-inner {\n  border-radius: 20px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n\t<div id=\"col-1940982388\" class=\"col medium-8 small-12 large-8\"  >\n\t\t\t\t<div class=\"col-inner dark\"  >\n\t\t\t\n\t\t\t\n\n\t<div id=\"text-998692803\" class=\"text\">\n\t\t\n\n<p><strong>Prof. Dr. \u00d6zg\u00fcr KILI\u00c7KESMEZ<br \/><\/strong><span style=\"font-size: 65%;\"><em>Radiologie Interven\u021bional\u0103 \/ Neuroradiologie Interven\u021bional\u0103<\/em><\/span><\/p>\n\t\t\n<style>\n#text-998692803 {\n  font-size: 1.25rem;\n}\n@media (min-width:550px) {\n  #text-998692803 {\n    font-size: 2rem;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n<p>Prof. Dr. K\u0131l\u0131\u00e7kesmez de\u021bine Certificatul de Competen\u021b\u0103 \u00een Radiologie din Turcia, Certificatul de Competen\u021b\u0103 \u00een Radiologie Interven\u021bional\u0103 din Turcia, Certificarea pentru tratamentul accidentului vascular cerebral \u0219i Certificatul European de Radiologie Interven\u021bional\u0103 (EBIR). \u00cen cariera sa academic\u0103, a c\u00e2\u0219tigat Premiul I Siemens pentru Radiologie \u00een 2008.<\/p>\n\n<a href=\"https:\/\/ozgurkilickesmez.com\/kimdir\/\" class=\"button white lowercase hide-for-small\" style=\"border-radius:15px;\">\n\t\t<span>CV<\/span>\n\t<\/a>\n\n\n<a href=\"https:\/\/ozgurkilickesmez.com\/kimdir\/oduller\/\" class=\"button white lowercase hide-for-small\" style=\"border-radius:15px;\">\n\t\t<span>Premii<\/span>\n\t<\/a>\n\n\n<a href=\"https:\/\/www.google.com\/search?sa=X&#038;sca_esv=02ef9b5328b381af&#038;tbm=lcl&#038;q=Prof+%C3%96zg%C3%BCr+K%C4%B1l%C4%B1%C3%A7kesmez+Recenzii&#038;rflfq=1&#038;num=20\" class=\"button white lowercase hide-for-small\" style=\"border-radius:15px;\" target=\"_blank\" rel=\"noopener\">\n\t\t<span>Recenzii<\/span>\n\t<\/a>\n\n\n<div class=\"row show-for-small\"  id=\"row-1327935139\">\n\n\n\t<div id=\"col-323974189\" class=\"col medium-6 small-6 large-6\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n<a href=\"https:\/\/ozgurkilickesmez.com\/kimdir\/\" class=\"button white lowercase expand\" style=\"border-radius:15px;\">\n\t\t<span>CV<\/span>\n\t<\/a>\n\n\n<a href=\"https:\/\/ozgurkilickesmez.com\/kimdir\/akademik-makaleler\/\" class=\"button white lowercase expand\" style=\"border-radius:15px;\">\n\t\t<span>Articole<\/span>\n\t<\/a>\n\n\n\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n\t<div id=\"col-577404272\" class=\"col medium-6 small-6 large-6\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n<a href=\"https:\/\/ozgurkilickesmez.com\/kimdir\/oduller\/\" class=\"button white lowercase expand\" style=\"border-radius:15px;\">\n\t\t<span>Premii<\/span>\n\t<\/a>\n\n\n<a href=\"https:\/\/www.google.com\/search?sa=X&#038;sca_esv=02ef9b5328b381af&#038;tbm=lcl&#038;q=Prof+%C3%96zg%C3%BCr+K%C4%B1l%C4%B1%C3%A7kesmez+Recenzii&#038;rflfq=1&#038;num=20\" class=\"button white lowercase expand\" style=\"border-radius:15px;\" target=\"_blank\" rel=\"noopener\">\n\t\t<span>Recenzii<\/span>\n\t<\/a>\n\n\n\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1940982388 > .col-inner {\n  margin: 0px 0px -20px 0px;\n}\n@media (min-width:550px) {\n  #col-1940982388 > .col-inner {\n    margin: 0px 0px 0px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-471121692 > .col-inner {\n  padding: 30px 30px 1px 30px;\n  border-radius: 20px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\n\t\t\n<style>\n#section_494268135 {\n  padding-top: 30px;\n  padding-bottom: 30px;\n}\n<\/style>\n\t<\/section>\n\t<\/span><\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_89 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Con\u021binutul articolului<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #ffffff;color:#ffffff\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #ffffff;color:#ffffff\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Diferentele_dintre_radiofrecventa_si_microunde\" >Diferen\u021bele dintre radiofrecven\u021b\u0103 \u0219i microunde<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Indicatii_pentru_MWA_sau_RFA_la_nodulii_tiroidieni_benigni\" >Indica\u021bii pentru MWA sau RFA la nodulii tiroidieni benigni<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Utilizarea_MWA_sau_RFA_in_cancerul_tiroidian_recidivant\" >Utilizarea MWA sau RFA \u00een cancerul tiroidian recidivant<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#MWA_sau_RFA_in_cancerul_tiroidian_primar\" >MWA sau RFA \u00een cancerul tiroidian primar<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Utilizarea_MWA_sau_RFA_in_neoplaziile_foliculare\" >Utilizarea MWA sau RFA \u00een neoplaziile foliculare<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Evaluari_inainte_de_MWA_sau_RFA\" >Evalu\u0103ri \u00eenainte de MWA sau RFA<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Utilizarea_medicamentelor_anticoagulante_si_antiagregante_trombocitare\" >Utilizarea medicamentelor anticoagulante \u0219i antiagregante trombocitare<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Tehnicile_MWA_sau_RFA_pentru_nodulii_tiroidieni_benigni\" >Tehnicile MWA sau RFA pentru nodulii tiroidieni benigni<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Selectia_tehnicii_MWA_sau_RFA_in_cazurile_de_cancer_recidivant\" >Selec\u021bia tehnicii MWA sau RFA \u00een cazurile de cancer recidivant<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Monitorizarea_clinica_post-MWA_sau_RFA\" >Monitorizarea clinic\u0103 post-MWA sau RFA<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Monitorizarea_post-tratament_MWA_sau_RFA_dupa_tratamentul_AFTN_nodul_toxic\" >Monitorizarea post-tratament MWA sau RFA dup\u0103 tratamentul AFTN (nodul toxic)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Monitorizarea_recurentei_cancerului_tiroidian_cervical\" >Monitorizarea recuren\u021bei cancerului tiroidian cervical<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Protocoalele_de_monitorizare_in_cancerul_tiroidian_primar\" >Protocoalele de monitorizare \u00een cancerul tiroidian primar<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Candidatura_nodulilor_tiroidieni_benigni_pentru_MWA_sau_RFA\" >Candidatura nodulilor tiroidieni benigni pentru MWA sau RFA<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Adequarea_tratamentului_MWA_sau_RFA_intr-o_singura_sesiune\" >Adequarea tratamentului MWA sau RFA \u00eentr-o singur\u0103 sesiune<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Eficacitatea_MWA_sau_RFA_in_tratamentul_OTN\" >Eficacitatea MWA sau RFA \u00een tratamentul OTN<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Rolul_MWA_sau_RFA_in_cancerul_tiroidian_recidivant\" >Rolul MWA sau RFA \u00een cancerul tiroidian recidivant<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Efectele_MWA_sau_RFA_in_cancerul_tiroidian_primar\" >Efectele MWA sau RFA \u00een cancerul tiroidian primar<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Siguranta_si_efectele_secundare_ale_MWA_sau_RFA\" >Siguran\u021ba \u0219i efectele secundare ale MWA sau RFA<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Intrebari_frecvente\" >\u00centreb\u0103ri frecvente<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/ablatia-nodulilor-tiroidieni\/#Resurse_suplimentare_si_documente\" >Resurse suplimentare \u0219i documente<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Diferentele_dintre_radiofrecventa_si_microunde\"><\/span>Diferen\u021bele dintre radiofrecven\u021b\u0103 \u0219i microunde<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><iframe title=\"Tiroid Embolizasyonu Hangi Hastal\u0131klarda Kullan\u0131l\u0131r, Nas\u0131l Yap\u0131l\u0131r ve Riskli midir?\" width=\"1020\" height=\"574\" src=\"https:\/\/www.youtube.com\/embed\/5-P2CBgGka8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<p>Ambele sunt metode similare, cu sisteme de r\u0103cire, care transform\u0103 energia \u00een c\u0103ldur\u0103; capetele acelor aplicate, vizualizate prin ultrasunete, genereaz\u0103 leziuni termice la nodul, iar energia este oprit\u0103 \u00een \u021besuturile normale. Spre deosebire de radiofrecven\u021b\u0103, aceasta dispune de o plac\u0103 de \u00eemp\u0103m\u00e2ntare.<\/p>\n<p>Procedura de abla\u021bie cu radiofrecven\u021b\u0103 dureaz\u0103 mai mult, \u00een timp ce cu microunde se realizeaz\u0103 \u00eentr-un timp mai scurt. \u00cen special, pentru noduli de peste 2 cm, alegerea metodei cu microunde face procedura mai confortabil\u0103. Metoda cu microunde este, de asemenea, aproximativ cu 10-15% mai scump\u0103 dec\u00e2t radiofrecven\u021ba.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Indicatii_pentru_MWA_sau_RFA_la_nodulii_tiroidieni_benigni\"><\/span>Indica\u021bii pentru MWA sau RFA la nodulii tiroidieni benigni<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Ablarea cu radiofrecven\u021b\u0103 este o metod\u0103 de tratament preferat\u0103 pentru nodulii tiroidieni benigni \u00een anumite situa\u021bii. Tratamentul se aplic\u0103 \u00een func\u021bie de diver\u0219i factori, cum ar fi dimensiunea sau pozi\u021bia nodulului. Simptomele experimentate de pacien\u021bi \u0219i problemele cosmetice joac\u0103 un rol important \u00een decizia de a interveni.<\/p>\n<p>MWA sau RFA sunt preferate \u00een tratamentul nodulilor simptomatici, deoarece aceste simptome pot afecta negativ via\u021ba de zi cu zi a pacientului. Indica\u021biile pentru nodulii tiroidieni simptomatici sunt urm\u0103toarele:<\/p>\n<ul>\n<li aria-level=\"1\">Durerea sau senza\u021bia de disconfort cauzat\u0103 de nodul.<\/li>\n<li aria-level=\"1\">Disfagia sau senza\u021bia de corp str\u0103in, care duc la dificult\u0103\u021bi la \u00eenghi\u021bire.<\/li>\n<li aria-level=\"1\">Noduli vizibil mari care genereaz\u0103 probleme estetice \u00een zona g\u00e2tului.<\/li>\n<\/ul>\n<p>Acest tip de tratament variaz\u0103 \u00een func\u021bie de dimensiunea \u0219i localizarea nodulului. \u00cen special, la pacien\u021bii cu spa\u021biu cervical restr\u00e2ns, MWA sau RFA pot fi aplicate \u00een stadii incipiente din cauza \u00eengrijor\u0103rilor estetice. De asemenea, exist\u0103 o rela\u021bie direct\u0103 \u00eentre dimensiunea nodulului \u0219i severitatea simptomelor; cu c\u00e2t simptomele sunt mai severe, cu at\u00e2t necesitatea aplic\u0103rii MWA sau RFA cre\u0219te.<\/p>\n<p>MWA sau ablarea cu radiofrecven\u021b\u0103 este indicat\u0103 conform urm\u0103toarelor criterii:<\/p>\n<ul>\n<li aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6005940\/\" target=\"_blank\" rel=\"noopener\">Observarea unei cre\u0219teri continue la nodulii mari (2 cm \u0219i peste).<\/a><\/li>\n<li aria-level=\"1\">Noduli f\u0103r\u0103 calcific\u0103ri dense.<\/li>\n<\/ul>\n<p>Aplicabilitatea MWA sau RFA este determinat\u0103 \u0219i de caracteristicile nodulului la imagistica prin ultrasunete \u0219i de rezultatele biopsiilor efectuate. La nodulii confirma\u021bi benign prin aspirare cu ac fin sau biopsie cu ac gros, repetarea biopsiei nu este, de obicei, necesar\u0103. Aceast\u0103 op\u021biune de tratament trebuie planificat\u0103 \u00een func\u021bie de localizarea nodulului \u0219i rela\u021bia acestuia cu \u021besuturile \u00eenconjur\u0103toare.<\/p>\n<p><span data-sheets-root=\"1\">\n\t<section class=\"section\" id=\"section_1152622982\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t\t\t\t\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n\n<div class=\"row\"  id=\"row-1284079620\">\n\n\n\t<div id=\"col-1086854962\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner box-shadow-2\"  >\n\t\t\t\n\t\t\t\n\n<div class=\"row\"  id=\"row-774747467\">\n\n\n\t<div id=\"col-675879281\" class=\"col whatsapp-alani hide-for-small medium-3 small-12 large-3\"  >\n\t\t\t\t<div class=\"col-inner box-shadow-2\" style=\"background-color:rgb(37, 211, 102);\" >\n\t\t\t\n\t\t\t\n\n\t<div id=\"text-3364968162\" class=\"text\">\n\t\t\n\n<p><a href=\"https:\/\/api.whatsapp.com\/send\/?phone=905405032303&amp;text=Bun\u0103%2C+v\u0103+contactez+de+pe+https%3A%2F%2Fozgurkilickesmez.com%2F&amp;type=phone_number&amp;app_absent=0\"><span style=\"color: #ffffff;\">WhatsApp 24\/7 <br \/>Apas\u0103 <\/span><span style=\"color: #ffffff;\">Aici!<\/span><\/a><\/p>\n\t\t\n<style>\n#text-3364968162 {\n  font-size: 1.5rem;\n  text-align: center;\n  color: rgb(255,255,255);\n}\n#text-3364968162 > * {\n  color: rgb(255,255,255);\n}\n<\/style>\n\t<\/div>\n\t\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-675879281 > .col-inner {\n  padding: 30px 0px 12px 0px;\n  margin: 0px 0px -31px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n\t<div id=\"col-1517246050\" class=\"col show-for-small medium-3 small-12 large-3\"  >\n\t\t\t\t<div class=\"col-inner box-shadow-2\" style=\"background-color:rgb(37, 211, 102);\" >\n\t\t\t\n\t\t\t\n\n\t<div id=\"text-3373409682\" class=\"text\">\n\t\t\n\n<p><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/api.whatsapp.com\/send\/?phone=905405032303&amp;text=Bun\u0103%2C+v\u0103+contactez+de+pe+https%3A%2F%2Fozgurkilickesmez.com%2F&amp;type=phone_number&amp;app_absent=0\">Apas\u0103 aici pentru suport WhatsApp 24\/7!<\/a><\/span><\/p>\n\t\t\n<style>\n#text-3373409682 {\n  font-size: 1.25rem;\n  text-align: center;\n  color: rgb(255,255,255);\n}\n#text-3373409682 > * {\n  color: rgb(255,255,255);\n}\n@media (min-width:550px) {\n  #text-3373409682 {\n    font-size: 1.5rem;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1517246050 > .col-inner {\n  padding: 20px 0px 1px 0px;\n  margin: 0px 0px 0px 0px;\n  border-radius: 100px;\n}\n@media (min-width:550px) {\n  #col-1517246050 > .col-inner {\n    margin: 0px 0px -40px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n\n\t<div id=\"col-407316341\" class=\"col medium-9 small-12 large-9\"  >\n\t\t\t\t<div class=\"col-inner text-left\"  >\n\t\t\t\n\t<div class=\"is-border\"\n\t\tstyle=\"border-width:0px 0px 0px 0px;margin:0px 0px 0px 0px;\">\n\t<\/div>\n\t\t\t\n\n<div class=\"row\"  id=\"row-789303008\">\n\n\n\t<div id=\"col-1997618188\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f8836-o1\" lang=\"tr-TR\" dir=\"ltr\" data-wpcf7-id=\"8836\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/ro\/wp-json\/wp\/v2\/posts\/9487#wpcf7-f8836-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"8836\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.2.3\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"tr_TR\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f8836-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"sp-form\">\n\t<div class=\"col-row\">\n\t\t<div class=\"col-quarter\">\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"text-340\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"name\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Nume\" value=\"\" type=\"text\" name=\"text-340\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"col-quarter\">\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel-10\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" autocomplete=\"name\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Telefon\" value=\"\" type=\"tel\" name=\"tel-10\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"col-quarter\">\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email-563\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" autocomplete=\"name\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"E-mail\" value=\"\" type=\"email\" name=\"email-563\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"col-quarter\">\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"TRIMITE\" \/>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"192\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1997618188 > .col-inner {\n  margin: 0px 0px -60px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n\t<div id=\"col-1836728505\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n\t<div id=\"text-2264632424\" class=\"text\">\n\t\t\n\n<p>*V\u0103 recomand\u0103m s\u0103 completa\u021bi toate c\u00e2mpurile pentru a primi cel mai bun r\u0103spuns posibil.<\/p>\n\t\t\n<style>\n#text-2264632424 {\n  font-size: 0.85rem;\n  line-height: 1.5;\n}\n@media (min-width:550px) {\n  #text-2264632424 {\n    line-height: 0.75;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1836728505 > .col-inner {\n  margin: 0px 0px -40px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-407316341 > .col-inner {\n  padding: 0px 0px 0px 0px;\n  margin: 0px 0px -20px 0px;\n}\n@media (min-width:550px) {\n  #col-407316341 > .col-inner {\n    padding: 20px 0px 0px 0px;\n    margin: 0px 0px -66px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1086854962 > .col-inner {\n  padding: 30px 10px 0px 10px;\n  border-radius: 30px;\n}\n@media (min-width:550px) {\n  #col-1086854962 > .col-inner {\n    padding: 0px 20px 0px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\n\t\t\n<style>\n#section_1152622982 {\n  padding-top: 30px;\n  padding-bottom: 30px;\n}\n<\/style>\n\t<\/section>\n\t<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Utilizarea_MWA_sau_RFA_in_cancerul_tiroidian_recidivant\"><\/span>Utilizarea MWA sau RFA \u00een cancerul tiroidian recidivant<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-6560 size-full\" src=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/05\/TIROID-ABLASYON-e1722081992163.jpg\" alt=\"Imagine a abla\u021biei tiroidiene\" width=\"1904\" height=\"644\" title=\"\" srcset=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/05\/TIROID-ABLASYON-e1722081992163.jpg 1904w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/05\/TIROID-ABLASYON-e1722081992163-300x101.jpg 300w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/05\/TIROID-ABLASYON-e1722081992163-1024x346.jpg 1024w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/05\/TIROID-ABLASYON-e1722081992163-1536x520.jpg 1536w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/05\/TIROID-ABLASYON-e1722081992163-768x260.jpg 768w\" sizes=\"(max-width: 1904px) 100vw, 1904px\" \/><\/p>\n<p>\u00cen cazurile de cancer tiroidian recidivant, ablarea cu microunde sau radiofrecven\u021b\u0103 (MWA sau RFA) reprezint\u0103 o metod\u0103 eficient\u0103, mai ales atunci c\u00e2nd op\u021biunile chirurgicale sunt limitate. Aceast\u0103 metod\u0103 poate fi utilizat\u0103 ca alternativ\u0103 la interven\u021bia chirurgical\u0103 sau \u00een scopuri curative \u0219i paliative.<\/p>\n<p>Ini\u021bial, a fost utilizat\u0103 \u00een 2001 la opt pacien\u021bi. Aceast\u0103 aplicare a fost sus\u021binut\u0103 de diverse studii \u0219i de dou\u0103 meta-analize. Cercet\u0103rile recente arat\u0103 c\u0103 MWA sau RFA ofer\u0103 rezultate de succes la pacien\u021bii care necesit\u0103 interven\u021bie chirurgical\u0103, dar prezint\u0103 un risc chirurgical ridicat.<\/p>\n<p>Indica\u021biile pentru MWA sau RFA \u00een cancerul tiroidian recidivant sunt urm\u0103toarele:<\/p>\n<ul>\n<li aria-level=\"1\">Pacien\u021bii cu risc chirurgical ridicat.<\/li>\n<li aria-level=\"1\">Complica\u021biile cauzate de interven\u021biile chirurgicale anterioare.<\/li>\n<li aria-level=\"1\">Persoanele cu func\u021bie pulmonar\u0103 deficitar\u0103 sau cu boli cardiovasculare severe.<\/li>\n<li aria-level=\"1\">Pacien\u021bii care nu sunt candida\u021bi pentru chirurgie din cauza v\u00e2rstei \u00eenaintate.<\/li>\n<\/ul>\n<p>MWA sau RFA ar trebui aplicate atunci c\u00e2nd este posibil\u0103 abla\u021bia complet\u0103 a tumorii din punct de vedere imagistic. De asemenea, nu trebuie s\u0103 existe metastaze retro-g\u00e2t. \u00cen scop curativ, este recomandat\u0103 atunci c\u00e2nd num\u0103rul tumorilor recidivante este de trei sau mai pu\u021bin \u0219i diametrul celui mai mare nodul este mai mic de 1,5\u20132 cm.<\/p>\n<p>MWA sau RFA pot fi, de asemenea, preferate pentru reducerea simptomelor \u0219i \u00eembun\u0103t\u0103\u021birea calit\u0103\u021bii vie\u021bii, reu\u0219ind, de obicei, s\u0103 gestioneze cu succes tumorile recidivante f\u0103r\u0103 complica\u021bii semnificative.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"MWA_sau_RFA_in_cancerul_tiroidian_primar\"><\/span>MWA sau RFA \u00een cancerul tiroidian primar<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Cancerul tiroidian primar este, de obicei, tratat prin chirurgie, \u00eens\u0103 \u00een anumite situa\u021bii MWA sau RFA pot fi considerate ca op\u021biuni alternative, \u00een special pentru pacien\u021bii care nu sunt candida\u021bi pentru interven\u021bii chirurgicale.<\/p>\n<p>Studiile efectuate la pacien\u021bii cu microcarcinom papilar tiroidian au ar\u0103tat c\u0103 MWA sau RFA asigur\u0103 o abla\u021bie local\u0103 eficient\u0103. Rezultatele acestor studii prezint\u0103 constat\u0103ri pozitive at\u00e2t pe termen scurt, c\u00e2t \u0219i dup\u0103 o urm\u0103rire de patru ani.<\/p>\n<p>Metode de abla\u021bie termic\u0103:<\/p>\n<ul>\n<li aria-level=\"1\">Ablarea cu radiofrecven\u021b\u0103 (RFA)<\/li>\n<li aria-level=\"1\">Ablarea cu laser (LA)<\/li>\n<li aria-level=\"1\">Ablarea cu microunde<\/li>\n<\/ul>\n<p>\u00cen stadiile avansate ale cancerului tiroidian, RFA \u0219i LA au fost utilizate ca tratamente paliative. \u00cen cancerul tiroidian anaplastic sau medular avansat, aceste metode au redus simptomele de compresie la unii pacien\u021bi. Totu\u0219i, nu exist\u0103 un consens privind eficacitatea clinic\u0103 a abla\u021biei termice \u00een aceste tipuri de cancer, suger\u00e2nd c\u0103 efectul metodei poate fi limitat.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Utilizarea_MWA_sau_RFA_in_neoplaziile_foliculare\"><\/span>Utilizarea MWA sau RFA \u00een neoplaziile foliculare<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><iframe title=\"Tiroid Tedavisinde Mikrodalga Ablasyon \u0130\u015flemi Nas\u0131l Uygulan\u0131r? (Uygulamal\u0131 Anlat\u0131m)\" width=\"1020\" height=\"574\" src=\"https:\/\/www.youtube.com\/embed\/yYIgGvW55bM?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<p>\u00cen tratamentul neoplaziilor foliculare, abordarea prin ablare cu microunde sau radiofrecven\u021b\u0103 a atras o aten\u021bie considerabil\u0103 \u00een ultimii ani. MWA sau RFA sunt recomandate ca op\u021biune alternativ\u0103, \u00een special pentru pacien\u021bii care nu sunt candida\u021bi pentru interven\u021bii chirurgicale.<\/p>\n<p>Studiile au ar\u0103tat c\u0103 MWA sau RFA sunt sigure \u0219i eficiente \u00een nodulii tiroidieni benigni, \u00eens\u0103, \u00een cazul neoplaziilor foliculare, exist\u0103 limit\u0103ri \u0219i aspecte care trebuie luate \u00een considerare:<\/p>\n<ul>\n<li aria-level=\"1\">Dimensiunea neoplazmei: MWA sau RFA sunt adecvate pentru leziuni mai mici de 2 cm.<\/li>\n<li aria-level=\"1\">Clasificarea Bethesda: leziunile de grad Bethesda-3 sau Bethesda-4 pot prezenta risc.<\/li>\n<\/ul>\n<p>Aceste condi\u021bii indic\u0103 faptul c\u0103 MWA sau RFA pot prezenta riscuri poten\u021biale \u00een cazul neoplaziilor foliculare \u0219i c\u0103 trebuie utilizate cu precau\u021bie, \u00een special \u00een situa\u021biile cu risc de malignitate. Studii suplimentare \u0219i experien\u021ba clinic\u0103 vor determina siguran\u021ba \u0219i eficacitatea acestor metode, motiv pentru care o evaluare cuprinz\u0103toare \u00eenainte de tratament este esen\u021bial\u0103. Utilizarea MWA sau RFA trebuie evaluat\u0103 conform unor criterii specifice, iar situa\u021bia fiec\u0103rui pacient trebuie abordat\u0103 individual.<\/p>\n<p><span data-sheets-root=\"1\">\n\t<section class=\"section dark\" id=\"section_57168987\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t\t\t\t\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\r\n\r\n\t<div id=\"gap-426504099\" class=\"gap-element clearfix hide-for-medium\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-426504099 {\n  padding-top: 10px;\n}\n<\/style>\n\t<\/div>\n\t\r\n\r\n<div class=\"row align-middle\"  id=\"row-145832166\">\r\n\r\n\n\t<div id=\"col-107757872\" class=\"col medium-8 small-12 large-8\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\r\n\r\n\t<div id=\"text-2296365205\" class=\"text\">\n\t\t\r\n\r\n<div><strong>Contacteaz\u0103-l acum pe Prof. Dr. \u00d6zg\u00fcr K\u0131l\u0131\u00e7kesmez pentru informa\u021bii detaliate \u0219i pentru a programa o consulta\u021bie!<\/strong><\/div>\r\n\t\t\n<style>\n#text-2296365205 {\n  font-size: 1.25rem;\n  text-align: center;\n}\n@media (min-width:550px) {\n  #text-2296365205 {\n    font-size: 1.15rem;\n  }\n}\n@media (min-width:850px) {\n  #text-2296365205 {\n    font-size: 1.5rem;\n    text-align: left;\n  }\n}\n<\/style>\n\t<\/div>\n\t\r\n\r\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-107757872 > .col-inner {\n  padding: 20px 0px 0px 0px;\n  margin: 0px 0px -10px 0px;\n}\n@media (min-width:550px) {\n  #col-107757872 > .col-inner {\n    padding: 0px 0px 0px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\r\n\n\t<div id=\"col-2083259740\" class=\"col medium-4 small-12 large-4\"  >\n\t\t\t\t<div class=\"col-inner text-center\"  >\n\t\t\t\n\t\t\t\r\n\r\n<a href=\"https:\/\/api.whatsapp.com\/send\/?phone=905405032303&#038;text=Bun\u0103%2C+v\u0103+contactez+de+pe+https%3A%2F%2Fozgurkilickesmez.com%2F&#038;type=phone_number&#038;app_absent=0\" target=\"_blank\" class=\"button alert is-small box-shadow-5\" rel=\"noopener\" style=\"border-radius:10px;padding:5px 20px 5px 20px;\">\n\t\t<span>Contact prin Whatsapp<\/span>\n\t<i class=\"icon-whatsapp\" aria-hidden=\"true\"><\/i><\/a>\n\r\n\r\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-2083259740 > .col-inner {\n  padding: 20px 0px 0px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\r\n\r\n<\/div>\r\n\r\n\t\t<\/div>\n\n\t\t\n<style>\n#section_57168987 {\n  padding-top: 0px;\n  padding-bottom: 0px;\n  background-color: #396cf0;\n}\n<\/style>\n\t<\/section>\n\t\r\n\t<div id=\"gap-2053914862\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-2053914862 {\n  padding-top: 20px;\n}\n<\/style>\n\t<\/div>\n\t\r\n<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Evaluari_inainte_de_MWA_sau_RFA\"><\/span>Evalu\u0103ri \u00eenainte de MWA sau RFA<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>\u00cen tratamentul nodulilor tiroidieni \u0219i al cancerului tiroidian recidivant, este esen\u021bial\u0103 o evaluare atent\u0103 \u00eenainte de a opta pentru ablarea cu microunde sau radiofrecven\u021b\u0103. \u00cen acest proces, sunt necesare diverse teste de laborator \u0219i imagistice pentru a determina corect starea pacientului. \u00cen primul r\u00e2nd, nodulii tiroidieni sunt examina\u021bi detaliat cu ultrasunete (US) pentru a evalua structura nodulilor \u0219i rela\u021bia cu structurile anatomice \u00eenconjur\u0103toare. \u00cen timpul acestei examin\u0103ri se evalueaz\u0103, printre altele:<\/p>\n<ul>\n<li aria-level=\"1\">Dimensiunea nodulilor,<\/li>\n<li aria-level=\"1\">Echogenitatea,<\/li>\n<li aria-level=\"1\">Procentul de component\u0103 solid\u0103,<\/li>\n<li aria-level=\"1\">Vascularizarea intern\u0103,<\/li>\n<\/ul>\n<p>\u00cen cadrul testelor de laborator se includ:<\/p>\n<ul>\n<li aria-level=\"1\">Hemograma complet\u0103,<\/li>\n<li aria-level=\"1\">Testele de coagulare (timpul de s\u00e2ngerare, timpul de protrombin\u0103, timpul par\u021bial de tromboplastin\u0103 activat\u0103),<\/li>\n<li aria-level=\"1\">Testele de func\u021bie tiroidian\u0103 (TSH, T3, fT4),<\/li>\n<\/ul>\n<p>\u00cen caz de cancer tiroidian recidivant, suplimentar trebuie m\u0103surate:<\/p>\n<ul>\n<li aria-level=\"1\">TSH seric,<\/li>\n<li aria-level=\"1\">Tioglobulin\u0103 (Tg),<\/li>\n<li aria-level=\"1\">Nivelurile de anticorpi anti-Tg,<\/li>\n<\/ul>\n<p>Aceste teste pot indica indirect succesul procedurii MWA sau RFA. Din punct de vedere imagistic, tomografia computerizat\u0103 (CT) a g\u00e2tului \u0219i RMN-ul pot fi utilizate pentru a detecta extinderea nodulilor \u0219i eventualele leziuni suplimentare. Aceste evalu\u0103ri clarific\u0103 starea pacientului \u00eenainte de tratament \u0219i furnizeaz\u0103 date importante pentru monitorizarea post-procedur\u0103.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Utilizarea_medicamentelor_anticoagulante_si_antiagregante_trombocitare\"><\/span>Utilizarea medicamentelor anticoagulante \u0219i antiagregante trombocitare<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>\u00cenainte de procedura MWA sau RFA, pacien\u021bii cu risc de s\u00e2ngerare trebuie examina\u021bi atent. Persoanele aflate \u00een tratament cu anticoagulante, \u00een special cele care folosesc aspirin\u0103 sau clopidogrel, li se recomand\u0103 s\u0103 \u00eentrerup\u0103 administrarea acestor medicamente pentru o anumit\u0103 perioad\u0103 \u00eenainte de procedur\u0103. Duratele de \u00eentrerupere sunt urm\u0103toarele:<\/p>\n<ul>\n<li aria-level=\"1\">Aspirin\u0103 sau clopidogrel: 5 zile<\/li>\n<li aria-level=\"1\">Warfarin: 3-5 zile<\/li>\n<li aria-level=\"1\">Heparin\u0103: 4-6 ore<\/li>\n<\/ul>\n<p>Programul de administrare a medicamentelor post-procedur\u0103 ar trebui s\u0103 fie stabilit astfel:<\/p>\n<ul>\n<li aria-level=\"1\">Heparin\u0103: la 2-6 ore dup\u0103 MWA sau RFA<\/li>\n<li aria-level=\"1\">Warfarin: \u00een noaptea urm\u0103toare MWA sau RFA<\/li>\n<li aria-level=\"1\">Aspirin\u0103 sau clopidogrel: \u00een ziua urm\u0103toare MWA sau RFA<\/li>\n<\/ul>\n<p>Medicii trebuie s\u0103 planifice \u00eentreruperea tratamentului anticoagulant \u0219i antiagregant, \u021bin\u00e2nd cont de starea general\u0103 de s\u0103n\u0103tate a pacientului \u0219i de specificul procedurii. \u00cen special, atunci c\u00e2nd se \u00eentrerupe utilizarea inhibitorilor de agregare plachetar\u0103, este recomandat s\u0103 se solicite consultul unui cardiolog \u0219i s\u0103 se \u021bin\u0103 cont de preferin\u021bele pacientului. Dac\u0103 este necesar, se poate trece la administrarea unei heparine cu timp de \u00eenjum\u0103t\u0103\u021bire scurt.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Tehnicile_MWA_sau_RFA_pentru_nodulii_tiroidieni_benigni\"><\/span>Tehnicile MWA sau RFA pentru nodulii tiroidieni benigni<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>\u00cen tratamentul nodulilor tiroidieni benigni, ablarea cu microunde sau radiofrecven\u021b\u0103 reprezint\u0103 o abordare minim invaziv\u0103, ideal\u0103 pentru pacien\u021bii care nu sunt candida\u021bi pentru interven\u021bii chirurgicale sau care nu doresc s\u0103 se supun\u0103 chirurgiei.<\/p>\n<p>\u00cen procedura de MWA sau RFA efectuat\u0103 sub anestezie local\u0103, se prefer\u0103 injec\u021bia de lidocain peritiroidian pentru controlul durerii, asigur\u00e2nd astfel confortul pacientului. Pentru a reduce durerea \u00een timpul procedurii, se administreaz\u0103 o cantitate adecvat\u0103 de lidocain pe piele \u0219i pe capsula tiroidian\u0103. Tehnicile utilizate includ:<\/p>\n<ul>\n<li aria-level=\"1\">Abordarea trans-istmic\u0103: Electrodul RF este plasat prin isthmusul glandei tiroidiene.<\/li>\n<li aria-level=\"1\">Tehnica &#8220;moving-shot&#8221;: Electrodul este tras din partea cea mai profund\u0103 a nodulului spre suprafa\u021b\u0103.<\/li>\n<\/ul>\n<p>Aceste tehnici asigur\u0103 un tratament eficient \u0219i sigur \u00een timpul abla\u021biei. Recent, au fost dezvoltate \u0219i tehnici de abla\u021bie vascular\u0103 ca supliment la aceast\u0103 metod\u0103, menite s\u0103 minimizeze recrescerea marginal\u0103 a nodulilor. Electrodul RF, monitorizat \u00een timp real cu ultrasunete, minimizeaz\u0103 riscul de leziuni termice. Absen\u021ba anesteziei generale sau a sed\u0103rii faciliteaz\u0103 detectarea precoce a complica\u021biilor \u0219i cre\u0219te siguran\u021ba pacientului pe parcursul procedurii.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Selectia_tehnicii_MWA_sau_RFA_in_cazurile_de_cancer_recidivant\"><\/span>Selec\u021bia tehnicii MWA sau RFA \u00een cazurile de cancer recidivant<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>\u00cen tratamentul cancerului tiroidian recidivant, MWA sau RFA a c\u0103p\u0103tat importan\u021b\u0103, mai ales din cauza dificult\u0103\u021bilor post-chirurgicale. \u00cen aceast\u0103 tehnic\u0103 se pune accent pe protejarea \u021besuturilor \u00eenconjur\u0103toare printr-o procedur\u0103 atent\u0103. Sele\u021bia capului electrodului se face \u00een func\u021bie de dimensiunea \u0219i localizarea tumorii; capetele electrodului de dimensiuni mici sunt ideale pentru tumorile din zone sensibile, permi\u021b\u00e2nd abla\u021bia \u00een siguran\u021b\u0103 a \u021besuturilor canceroase recidivante.<\/p>\n<p><strong>Tehnici standard:<\/strong><\/p>\n<ul>\n<li aria-level=\"1\">Injec\u021bia de lidocain perilezyonal\u0103<\/li>\n<li aria-level=\"1\">Tehnica de hidrodisec\u021bie<\/li>\n<li aria-level=\"1\">Tehnica &#8220;moving-shot&#8221;<\/li>\n<\/ul>\n<p>Tehnica de hidrodisec\u021bie creeaz\u0103 o zon\u0103 tampon \u00eentre tumoare \u0219i structurile vitale, protej\u00e2ndu-le \u00een timpul abla\u021biei. Se prefer\u0103 utilizarea unei solu\u021bii de dextroz\u0103 5% deoarece \u00eempiedic\u0103 transmiterea electric\u0103. Dextroza rece este injectat\u0103 continuu pentru a preveni r\u0103sp\u00e2ndirea termic\u0103. Fiecare tehnic\u0103 este aleas\u0103 cu grij\u0103 \u00een func\u021bie de localizarea tumorii \u0219i riscurile asociate, reduc\u00e2nd astfel complica\u021biile post-procedur\u0103.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Monitorizarea_clinica_post-MWA_sau_RFA\"><\/span>Monitorizarea clinic\u0103 post-MWA sau RFA<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Dup\u0103 MWA sau RFA, procesul de monitorizare pentru gestionarea nodulilor tiroidieni benigni nefunc\u021bionali include urm\u0103torii pa\u0219i. Imediat dup\u0103 finalizarea abla\u021biei, nodulul ar trebui s\u0103 capete temporar un aspect hiperecogenic la ultrasunete. Ulterior, pentru a evalua completitudinea abla\u021biei, se utilizeaz\u0103 imagistica cu tonuri de gri \u0219i Doppler color pentru a determina dac\u0103 por\u021biunea r\u0103mas\u0103 a nodulului prezint\u0103 vasculariza\u021bie. Dac\u0103 se identific\u0103 p\u0103r\u021bi viabile, poate exista un poten\u021bial de recrescare, caz \u00een care se poate considera o ablare suplimentar\u0103.<\/p>\n<p><em>\u00cen evalu\u0103rile post-MWA sau RFA se iau \u00een considerare urm\u0103toarele aspecte:<\/em><\/p>\n<ul>\n<li aria-level=\"1\">Scorul simptomatic asociat nodulului: simptome precum durerea de g\u00e2t, disfagia, senza\u021bia de corp str\u0103in, disconfortul \u0219i tusea sunt evaluate at\u00e2t de pacient, c\u00e2t \u0219i de medic.<\/li>\n<li aria-level=\"1\">Scorul cosmetic: modific\u0103rile aspectului pacientului sunt documentate de medic.<\/li>\n<\/ul>\n<p>\u00cen final, procentul de reducere a volumului se calculeaz\u0103 ca raportul dintre diferen\u021ba volumului ini\u021bial \u0219i cel final \u0219i volumul ini\u021bial, fiind un indicator obiectiv al eficacit\u0103\u021bii MWA sau RFA.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Monitorizarea_post-tratament_MWA_sau_RFA_dupa_tratamentul_AFTN_nodul_toxic\"><\/span>Monitorizarea post-tratament MWA sau RFA dup\u0103 tratamentul AFTN (nodul toxic)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Dup\u0103 tratamentul nodulului tiroidian autonom func\u021bional (AFTN), este esen\u021bial un plan de monitorizare detaliat pentru a evalua succesul aplic\u0103rii MWA sau RFA. Monitorizarea necesit\u0103 o abordare personalizat\u0103, \u00een care testele de func\u021bie tiroidian\u0103 (TSH, T3, fT4) se efectueaz\u0103 la fiecare control. \u00cen plus, se m\u0103soar\u0103 \u0219i nivelurile de anticorpi tiroidieni:<\/p>\n<ul>\n<li aria-level=\"1\">Nivelurile de anti-TPOAb \u0219i anti-TGAb reflect\u0103 modific\u0103rile func\u021biei tiroidiene.<\/li>\n<li aria-level=\"1\">\u00cen func\u021bie de modific\u0103rile hormonale, se pot face ajust\u0103ri ale dozei medicamentelor antitiroidiene, analizate \u00een trei categorii:\n<ul>\n<li aria-level=\"2\">Remisiune: starea de hipotiroidism dup\u0103 \u00eentreruperea medicamentului antitiroidian<\/li>\n<li aria-level=\"2\">\u00cembun\u0103t\u0103\u021bire: starea de hipotiroidism ameliorat\u0103 prin reducerea dozei<\/li>\n<li aria-level=\"2\">Lipsa r\u0103spunsului: nicio modificare a dozei<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Metodele imagistice sunt, de asemenea, critice. Examinarea cu ultrasunete (US) se efectueaz\u0103 la fiecare control pentru a evalua dimensiunea, volumul, vascularizarea \u0219i echogenitatea nodulului. Scanarea tiroidian\u0103 ajut\u0103 la clasificarea nodulilor, dup\u0103 cum urmeaz\u0103:<\/p>\n<ul>\n<li aria-level=\"1\">Tip 1: Nodul cald<\/li>\n<li aria-level=\"1\">Tip 2: Nodul cu captare similar\u0103 cu \u021besutul tiroidian extra-nodular<\/li>\n<li aria-level=\"1\">Tip 3: Nodul rece sau invizibil<\/li>\n<\/ul>\n<p>Dac\u0103 func\u021bia tiroidian\u0103 sau simptomele nu se rezolv\u0103 complet, se poate lua \u00een considerare repetarea MWA sau RFA sau alte tratamente alternative. Procesul de tratament trebuie ajustat cu grij\u0103 \u00een func\u021bie de r\u0103spunsul pacientului.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Monitorizarea_recurentei_cancerului_tiroidian_cervical\"><\/span>Monitorizarea recuren\u021bei cancerului tiroidian cervical<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Dup\u0103 MWA sau RFA, monitorizarea recuren\u021bei cancerului tiroidian cervical se realizeaz\u0103 conform unor protocoale specifice, care includ evalu\u0103ri clinice, de laborator \u0219i imagistice. Ini\u021bial, se evalueaz\u0103 volumul tumorii, diametrul maxim \u0219i vascularizarea prin ultrasunete, precum \u0219i prezen\u021ba tumorilor metastatice noi:<\/p>\n<ul>\n<li aria-level=\"1\">Volumul tumorii \u0219i diametrul maxim<\/li>\n<li aria-level=\"1\">Vascularizarea<\/li>\n<li aria-level=\"1\">Prezen\u021ba tumorilor metastatice noi<\/li>\n<\/ul>\n<p>Printre testele de laborator, se m\u0103soar\u0103 nivelul seric de Tg \u0219i anticorpii anti-Tg:<\/p>\n<ul>\n<li aria-level=\"1\">Nivelul seric de Tg<\/li>\n<li aria-level=\"1\">Anticorpi anti-Tg<\/li>\n<\/ul>\n<p>Ca metod\u0103 de imagistic\u0103, se recomand\u0103 un CT cu contrast, care poate identifica prezen\u021ba tumorilor viabile sau apari\u021bia unor tumori noi. Dac\u0103 se detecteaz\u0103 recidiva la ultrasunete sau CT, se pot planifica tratamente abla\u021bionale suplimentare. Dup\u0103 o abla\u021bie de succes, contrastarea tumorii scade sau dispare, aspect esen\u021bial pentru optimizarea rezultatelor tratamentului.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Protocoalele_de_monitorizare_in_cancerul_tiroidian_primar\"><\/span>Protocoalele de monitorizare \u00een cancerul tiroidian primar<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>\u00cen tratamentul cancerului tiroidian primar, monitorizarea post-MWA sau RFA are un impact semnificativ asupra s\u0103n\u0103t\u0103\u021bii pacientului. Un studiu prospectiv a stabilit urm\u0103torul program de monitorizare:<\/p>\n<ul>\n<li aria-level=\"1\">Luna 1,<\/li>\n<li aria-level=\"1\">Luna 3,<\/li>\n<li aria-level=\"1\">Luna 6,<\/li>\n<li aria-level=\"1\">Luna 12.<\/li>\n<\/ul>\n<p>La aceste intervale, starea pacientului este evaluat\u0103 prin US \u0219i US cu contrast. Realizarea CNB \u00een luna a treia este de importan\u021b\u0103 critic\u0103 pentru verificarea eficacit\u0103\u021bii procedurii. Rezultatele sus\u021bin monitorizarea anual\u0103 post-procedur\u0103 \u0219i o evaluare atent\u0103 pentru a detecta eventuale modific\u0103ri patologice \u00een glanda tiroidian\u0103 \u0219i \u00een ganglionii limfatici adiacen\u021bi:<\/p>\n<ul>\n<li aria-level=\"1\">Dezvoltarea metacronic\u0103 a PTC,<\/li>\n<li aria-level=\"1\">Metastaze noi \u00een ganglionii limfatici.<\/li>\n<\/ul>\n<p>Aceste situa\u021bii pot fi examinate detaliat prin CT. Dac\u0103 leziunile post-MWA sau RFA nu cresc ca dimensiune sau nu se modific\u0103, se recomand\u0103 evaluarea detaliat\u0103 prin CNB sau FNA. Aceste protocoale sunt esen\u021biale pentru gestionarea optim\u0103 a st\u0103rii de s\u0103n\u0103tate a pacientului.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Candidatura_nodulilor_tiroidieni_benigni_pentru_MWA_sau_RFA\"><\/span>Candidatura nodulilor tiroidieni benigni pentru MWA sau RFA<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Pentru nodulii tiroidieni benigni, ablarea cu microunde sau radiofrecven\u021b\u0103 (RFA) este recomandat\u0103 ca metod\u0103 de tratament eficient\u0103 pentru anumite tipuri de noduli. Candidatura pentru tratament este determinat\u0103 de caracteristicile structurale ale nodulului.<\/p>\n<p>MWA sau RFA sunt considerate tratamente de prim\u0103 linie pentru nodulii tiroidieni solizi sau predominant solizi, care sunt, de obicei, nefunc\u021bionali, iar rezultatele tratamentului sunt foarte bune. Eficacitatea tratamentului se m\u0103soar\u0103 prin reducerea volumului nodulului, precum \u0219i prin \u00eembun\u0103t\u0103\u021birile scorurilor simptomatice \u0219i cosmetice.<\/p>\n<p><strong>De asemenea, MWA sau RFA sunt recomandate \u00een:<\/strong><\/p>\n<ul>\n<li aria-level=\"1\">Nodulii cistici cu component\u0103 solid\u0103,<\/li>\n<li aria-level=\"1\">Nodulii tiroidieni complet solizi,<\/li>\n<li aria-level=\"1\">Nodulii tiroidieni nefunc\u021bionali.<\/li>\n<\/ul>\n<p><em>Compozi\u021bia nodulului \u0219i adecvarea tratamentului sunt clasificate dup\u0103 urm\u0103toarele caracteristici:<\/em><\/p>\n<ul>\n<li aria-level=\"1\">Nodulii cistici: MWA sau RFA sunt recomandate ca op\u021biune alternativ\u0103 dup\u0103 abla\u021bia cu etanol (EA) \u00een cazurile \u00een care simptomele persist\u0103 sau recidiva apare. O component\u0103 cistic\u0103 mare poate indica faptul c\u0103 EA ar fi mai adecvat\u0103.<\/li>\n<li aria-level=\"1\">Nodulii tiroidieni predominant cistici: \u00cen ace\u0219ti noduli, componenta cistic\u0103 variaz\u0103 \u00eentre 50-90%. EA este recomandat\u0103 ca tratament de prim\u0103 linie, iar \u00een caz de recidiv\u0103 sau de lips\u0103 de ameliorare complet\u0103 a simptomelor, se poate opta pentru MWA sau RFA.<\/li>\n<li aria-level=\"1\">Nodulii solizi: MWA sau RFA reprezint\u0103 o metod\u0103 eficient\u0103 de prim\u0103 linie, asigur\u00e2nd o reducere semnificativ\u0103 a volumului \u0219i necesit\u00e2nd, de regul\u0103, un num\u0103r redus de sesiuni de tratament.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Adequarea_tratamentului_MWA_sau_RFA_intr-o_singura_sesiune\"><\/span>Adequarea tratamentului MWA sau RFA \u00eentr-o singur\u0103 sesiune<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Ablarea cu microunde sau radiofrecven\u021b\u0103 pentru nodulii tiroidieni a dat rezultate de succes la mul\u021bi pacien\u021bi. Totu\u0219i, \u00een unele cazuri, o singur\u0103 sesiune de tratament poate fi insuficient\u0103, \u00een special la nodulii mari sau c\u00e2nd simptomele nu se amelioreaz\u0103 complet, necesit\u00e2nd sesiuni suplimentare. Monitoriz\u0103rile pe termen lung au ar\u0103tat c\u0103, \u00een cazurile \u00een care volumul nodulului dep\u0103\u0219e\u0219te 20 mL, o singur\u0103 sesiune este de obicei insuficient\u0103.<\/p>\n<p><strong>Principalele indica\u021bii pentru tratament suplimentar sunt:<\/strong><\/p>\n<ul>\n<li aria-level=\"1\">Persisten\u021ba simptomelor dup\u0103 tratament,<\/li>\n<li aria-level=\"1\">Rata de reducere a volumului (VRR) sub 50%,<\/li>\n<li aria-level=\"1\">Recrescerea tumorii.<\/li>\n<\/ul>\n<p>De\u0219i exist\u0103 incertitudini privind momentul \u0219i necesitatea tratamentului suplimentar, se recomand\u0103 monitorizarea atent\u0103 post-abla\u021bie. Pentru a asigura succesul pe termen lung, monitorizarea cre\u0219terii p\u0103r\u021bilor viabile ale nodulului este esen\u021bial\u0103 pentru a determina dac\u0103 pacientul necesit\u0103 tratament suplimentar.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Eficacitatea_MWA_sau_RFA_in_tratamentul_OTN\"><\/span>Eficacitatea MWA sau RFA \u00een tratamentul OTN<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>MWA sau RFA reprezint\u0103 o metod\u0103 non-chirurgical\u0103 important\u0103 utilizat\u0103 \u00een tratamentul OTN. Aceast\u0103 tehnic\u0103 produce o reducere semnificativ\u0103 a volumului nodulilor tiroidieni. Efectele aplic\u0103rii MWA sau RFA au fost studiate \u00een detaliu, iar rezultatele demonstreaz\u0103 succesul tratamentului.<\/p>\n<ul>\n<li aria-level=\"1\">\u00cen primele 6 luni, s-a observat o reducere a volumului \u00eentre 69% \u0219i 74,5%.<\/li>\n<li aria-level=\"1\">\u00cen lunile ulterioare, aceast\u0103 reducere poate ajunge p\u00e2n\u0103 la 75%.<\/li>\n<li aria-level=\"1\">Disconfortul cervical \u0219i problemele cosmetice s-au ameliorat paralel cu reducerea volumului.<\/li>\n<\/ul>\n<p>Efectele asupra func\u021biei tiroidiene sunt, de asemenea, remarcabile. Dup\u0103 tratament, la 21,7-50% dintre pacien\u021bi, utilizarea medicamentelor antitiroidiene a fost \u00eentrerupt\u0103, iar la 55,6-81,8% dintre pacien\u021bi nivelurile serice de TSH s-au normalizat. Aceste date indic\u0103 faptul c\u0103 MWA sau RFA reprezint\u0103 o alternativ\u0103 non-chirurgical\u0103 eficient\u0103 \u00een gestionarea OTN, cu un grad ridicat de satisfac\u021bie a pacien\u021bilor \u0219i o rat\u0103 sc\u0103zut\u0103 de complica\u021bii. \u00cen concluzie, MWA sau RFA se eviden\u021biaz\u0103 ca o metod\u0103 sigur\u0103 \u0219i eficient\u0103 pentru controlul nodulilor tiroidieni \u0219i al simptomelor tirotoxice.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Rolul_MWA_sau_RFA_in_cancerul_tiroidian_recidivant\"><\/span>Rolul MWA sau RFA \u00een cancerul tiroidian recidivant<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>\u00cen tratamentul cancerului tiroidian recidivant, ablarea cu radiofrecven\u021b\u0103 a c\u0103p\u0103tat importan\u021b\u0103 ca metod\u0103 non-chirurgical\u0103. Studiile au eviden\u021biat poten\u021bialul MWA sau RFA \u00een reducerea semnificativ\u0103 a dimensiunii tumorii \u0219i a nivelurilor serice de Tg. Un studiu a raportat c\u0103 o mare parte a tumorilor a disp\u0103rut complet dup\u0103 MWA sau RFA. Informa\u021biile ob\u021binute sunt urm\u0103toarele:<\/p>\n<ul>\n<li aria-level=\"1\">Rata de reducere a volumului tumorii: 50,9% \u2013 98,4%<\/li>\n<li aria-level=\"1\">Rata de dispari\u021bie complet\u0103: 68,8%<\/li>\n<li aria-level=\"1\">Rata recidivei \u00een zona tratat\u0103: 0%<\/li>\n<\/ul>\n<p>MWA sau RFA ofer\u0103 rate de succes mai mari atunci c\u00e2nd dimensiunea \u0219i num\u0103rul tumorilor sunt limitate. Studiile efectuate de Kim \u0219i colaboratorii s\u0103i au ar\u0103tat rezultate echivalente cu cele ale interven\u021biei chirurgicale pe termen lung, cu necesitatea unui num\u0103r mai mic de sesiuni de tratament \u0219i cu rate de recidiv\u0103 sc\u0103zute:<\/p>\n<ul>\n<li aria-level=\"1\">Num\u0103rul de tumori tratate: maxim trei pe pacient<\/li>\n<li aria-level=\"1\">Diametrul tumorii: mai mic de 2 cm<\/li>\n<li aria-level=\"1\">Ratele de recidiv\u0103 pe termen lung: f\u0103r\u0103 diferen\u021be semnificative \u00eentre MWA\/RFA \u0219i chirurgie<\/li>\n<\/ul>\n<p>\u00cen plus, un studiu a raportat c\u0103 peste jum\u0103tate dintre pacien\u021bii trata\u021bi cu MWA sau RFA au experimentat o ameliorare a simptomelor \u00een decurs de \u0219ase luni. Totu\u0219i, \u00een cazurile tehnic dificile, rata de e\u0219ec poate cre\u0219te, de obicei din cauza calcific\u0103rilor severe sau a localiz\u0103rii tumorii \u00een apropierea vaselor mari, caz \u00een care pot fi necesare sesiuni repetate.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Efectele_MWA_sau_RFA_in_cancerul_tiroidian_primar\"><\/span>Efectele MWA sau RFA \u00een cancerul tiroidian primar<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Ablarea cu microunde sau radiofrecven\u021b\u0103 a oferit rezultate promi\u021b\u0103toare \u00een tratamentul cancerului tiroidian primar. <a href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/thy.2015.0471\" target=\"_blank\" rel=\"noopener\">Un studiu prospectiv a demonstrat c\u0103 acest tratament conduce la o reducere semnificativ\u0103 a volumului pe termen scurt:<\/a><\/p>\n<ul>\n<li aria-level=\"1\">Reducere de 53% \u00een prima lun\u0103,<\/li>\n<li aria-level=\"1\">Reducere de 81% \u00een a treia lun\u0103,<\/li>\n<li aria-level=\"1\">Reducere de 92% \u00een a \u0219asea lun\u0103,<\/li>\n<li aria-level=\"1\">Reducere de 96% \u00een a dou\u0103sprezecea lun\u0103,<\/li>\n<li aria-level=\"1\">Reducere de 100% \u00een a optsprezecea lun\u0103.<\/li>\n<\/ul>\n<p>Rezultatele pe termen lung sunt similare, raport\u00e2ndu-se o reducere medie a volumului de 98,5% dup\u0103 patru ani, f\u0103r\u0103 recidive locale sau leziuni metastatice. Totu\u0219i, micile cancere detectate post-chirurgical \u0219i metastazele microscopice indic\u0103 c\u0103 capacitatea MWA sau RFA de a controla boala regional\u0103 poate fi limitat\u0103, suger\u00e2nd necesitatea unor cercet\u0103ri suplimentare.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Siguranta_si_efectele_secundare_ale_MWA_sau_RFA\"><\/span>Siguran\u021ba \u0219i efectele secundare ale MWA sau RFA<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Aceast\u0103 procedur\u0103 ofer\u0103 rezultate eficiente at\u00e2t pentru nodulii benigni, c\u00e2t \u0219i pentru cancerul tiroidian recidivant. C\u00e2nd este efectuat\u0103 de operatori experimenta\u021bi, MWA sau RFA este sigur\u0103 \u0219i bine tolerat\u0103, cu rate sc\u0103zute de complica\u021bii. Complica\u021biile \u00eent\u00e2mpinate \u00een timpul \u0219i dup\u0103 procedur\u0103 sunt, de obicei, u\u0219oare \u0219i gestionabile. \u00cen acest context, profilul de siguran\u021b\u0103 \u0219i toleran\u021b\u0103 al MWA sau RFA a fost analizat dup\u0103 cum urmeaz\u0103:<\/p>\n<p><strong>Complica\u021bii majore:<\/strong><\/p>\n<ul>\n<li aria-level=\"1\">Leziune recurent\u0103 a nervului laringei recurente<\/li>\n<li aria-level=\"1\">Leziune a nervului vag<\/li>\n<li aria-level=\"1\">Sindromul Horner<\/li>\n<li aria-level=\"1\">Leziune a nervului accesor spinal<\/li>\n<li aria-level=\"1\">Leziune a plexului brahial<\/li>\n<li aria-level=\"1\">Ruptura nodulului<\/li>\n<li aria-level=\"1\">Leziune termic\u0103 a glandei tiroidiene asupra esofagului<\/li>\n<\/ul>\n<p><strong>Complica\u021bii minore:<\/strong><\/p>\n<ul>\n<li aria-level=\"1\">Hematom<\/li>\n<li aria-level=\"1\">Grea\u021b\u0103<\/li>\n<li aria-level=\"1\">Arsur\u0103 cutanat\u0103<\/li>\n<li aria-level=\"1\">Tirotoxicoz\u0103 tranzitorie<\/li>\n<li aria-level=\"1\">Toxicitate cu lidocain\u0103<\/li>\n<li aria-level=\"1\">Hipertensiune<\/li>\n<li aria-level=\"1\">Durere<\/li>\n<\/ul>\n<p>Complica\u021biile devin rareori severe \u0219i, de obicei, pot fi rezolvate prin compresie sau tratamente simple. Modific\u0103rile de voce sunt cea mai frecvent \u00eent\u00e2lnit\u0103 complica\u021bie major\u0103, \u00eens\u0103 acestea sunt de obicei tranzitorii. Pentru a reduce riscul modific\u0103rilor de voce, se utilizeaz\u0103 abordarea trans-istmic\u0103 \u0219i tehnica &#8220;moving-shot&#8221;. Nervul vag \u0219i varia\u021biile anatomice ale nervului laringei recurente sunt luate \u00een considerare, necesit\u00e2nd o aten\u021bie deosebit\u0103 \u00een timpul procedurii. Este esen\u021bial ca procedura s\u0103 fie efectuat\u0103 sub ghidajul ultrasunetului pentru a preveni leziunile nervoase.<\/p>\n<p>Ruptura nodulului tiroidian se manifest\u0103 dup\u0103 procedur\u0103 prin umflarea brusc\u0103 a g\u00e2tului \u0219i durere, fiind gestionat\u0103, de obicei, prin metode conservative. \u00cen cazurile de abces, poate fi necesar\u0103 interven\u021bia chirurgical\u0103. Hematomele se gestioneaz\u0103 prin compresie, majoritatea vindec\u00e2ndu-se spontan \u00een c\u00e2teva s\u0103pt\u0103m\u00e2ni. \u00cen timpul plas\u0103rii electrodului, arterele tiroidiene sunt examinate cu aten\u021bie folosind ultrasunete Doppler pentru a minimiza riscul de s\u00e2ngerare sever\u0103.<\/p>\n<p>Hipotiroidismul post-MWA sau RFA, de\u0219i rareori, poate ap\u0103rea la pacien\u021bii cu niveluri crescute de anti-TPOAb sau cu disfunc\u021bii tiroidiene preexistente. Hipertiroidismul tranzitoriu poate ap\u0103rea ca efect secundar, \u00eens\u0103 este de regul\u0103 asimptomatic \u0219i revine la normal \u00een c\u00e2teva s\u0103pt\u0103m\u00e2ni. Durerea, cea mai frecvent\u0103 complica\u021bie minor\u0103, este de obicei gestionat\u0103 prin ajust\u0103ri adecvate \u00een timpul procedurii.<\/p>\n<p>\u00cen concluzie, MWA sau RFA este considerat\u0103 o metod\u0103 sigur\u0103 \u0219i bine tolerat\u0103 pentru tratamentul nodulilor tiroidieni, datorit\u0103 ratei sc\u0103zute de complica\u021bii \u0219i tehnicilor eficiente de gestionare, reprezent\u00e2nd o op\u021biune important\u0103 \u00een tratamentul nodulilor tiroidieni.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Intrebari_frecvente\"><\/span>\u00centreb\u0103ri frecvente<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-5990\" src=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular.jpg\" alt=\"\" width=\"1600\" height=\"400\" title=\"\" srcset=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular.jpg 1600w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular-300x75.jpg 300w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular-1024x256.jpg 1024w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular-1536x384.jpg 1536w\" sizes=\"(max-width: 1600px) 100vw, 1600px\" \/><\/p>\n<p><strong>C\u00e2t cost\u0103 tratamentul de abla\u021bie tiroidian\u0103?<\/strong><\/p>\n<p>Pre\u021burile tratamentului de abla\u021bie tiroidian\u0103 depind de diver\u0219i factori. \u00cen primul r\u00e2nd, tipul tratamentului influen\u021beaz\u0103 costul, iar loca\u021bia spitalului sau clinicii selectate joac\u0103, de asemenea, un rol important. Experien\u021ba \u0219i nivelul de specializare al medicului pot fi, de asemenea, factori determinan\u021bi. \u00cen spitalele private, costul acestui tratament este de obicei mai ridicat. \u00cen concluzie, pre\u021bul tratamentului de abla\u021bie tiroidian\u0103 variaz\u0103 de la un spital la altul \u0219i \u00een func\u021bie de metoda aplicat\u0103 (RF \/ Microunde).<\/p>\n<p><strong>Se poate efectua abla\u021bia la nodulii toxici?<\/strong><\/p>\n<p><iframe title=\"Toksik nod\u00fcllere ablasyon i\u015flemi yap\u0131l\u0131r m\u0131?\" width=\"563\" height=\"1000\" src=\"https:\/\/www.youtube.com\/embed\/B6IcqL6zeC8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<p>Da, tratamentul de abla\u021bie poate fi aplicat la nodulii toxici. Chiar dac\u0103 se identific\u0103 un num\u0103r mare de noduli, acest fapt nu afecteaz\u0103 eficacitatea tratamentului. \u00cen special, \u00een cazul hipertiroidismului, se urm\u0103re\u0219te reducerea nodulilor care produc exces de hormoni \u00een glanda tiroidian\u0103. Aceast\u0103 metod\u0103 poate fi luat\u0103 \u00een considerare ca alternativ\u0103 la tratamentul medicamentos sau chirurgical, \u00een func\u021bie de starea general\u0103 a pacientului \u0219i de caracteristicile nodulilor. Prin urmare, abla\u021bia cu laser poate fi recomandat\u0103 de medic \u00een func\u021bie de situa\u021bia pacientului.<\/p>\n<p><strong>Se administreaz\u0103 anestezie general\u0103 \u00een timpul abla\u021biei?<\/strong><\/p>\n<p>\u00cen timpul abla\u021biei, pacientul nu este anestezizat complet; dac\u0103 se efectueaz\u0103 o interven\u021bie chirurgical\u0103, pacientul poate fi anesteziat, \u00eens\u0103 \u00een cazurile care nu necesit\u0103 chirurgie, administrarea de sedative este suficient\u0103. Astfel, decizia de a anestezia complet pacientul depinde de natura procedurii.<\/p>\n<p><strong>Este abla\u021bia permanent\u0103?<\/strong><\/p>\n<p>Da, \u021besutul ablat devine necrotic \u0219i \u00ee\u0219i men\u021bine dimensiunea redus\u0103. \u00cen aproximativ 5% dintre cazuri poate ap\u0103rea recrescerea, \u00eens\u0103 acestea nu vor ajunge niciodat\u0103 la dimensiunile ini\u021biale.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Resurse_suplimentare_si_documente\"><\/span>Resurse suplimentare \u0219i documente<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><a href=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/A-6-year-single-center-prospective-follow-up-study-of-the-efficacy-of-radiofrequency-ablation-for-thyroid-nodules.pdf\">https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/A-6-year-single-center-prospective-follow-up-study-of-the-efficacy-of-radiofrequency-ablation-for-thyroid-nodules.pdf<\/a><\/p>\n<p><a href=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/European-Thyroid-Association-Survey-on-Use-of-Minimally-Invasive-Techniques-for-Thyroid-Nodules.pdf\">https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/European-Thyroid-Association-Survey-on-Use-of-Minimally-Invasive-Techniques-for-Thyroid-Nodules.pdf<\/a><\/p>\n<p><a href=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/US-Guided-Percutaneous-Radiofrequency-versus-Microwave-Ablation-for-Benign-Thyroid-Nodules.pdf\">https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/US-Guided-Percutaneous-Radiofrequency-versus-Microwave-Ablation-for-Benign-Thyroid-Nodules.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ablatia nodulilor tiroidieni este o procedur\u0103 minim invaziv\u0103 destinat\u0103 trat\u0103rii forma\u021biunilor benigne sau suspecte, f\u0103r\u0103 necesitatea interven\u021biei chirurgicale clasice. Aceasta utilizeaz\u0103 c\u0103ldura sau energia pentru distrugerea \u021besutului patologic. Metodele moderne de abla\u021bie includ radiofrecven\u021ba, laserul \u0219i microundele, toate realizate sub ghidaj ecografic. Acestea reduc dimensiunea nodulului \u0219i amelioreaz\u0103 simptomele compresive. Recuperarea dup\u0103 abla\u021bia tiroidian\u0103 este [&#8230;]\n","protected":false},"author":2,"featured_media":9488,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-9487","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts\/9487","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/comments?post=9487"}],"version-history":[{"count":2,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts\/9487\/revisions"}],"predecessor-version":[{"id":12069,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts\/9487\/revisions\/12069"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/media\/9488"}],"wp:attachment":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/media?parent=9487"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/categories?post=9487"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/tags?post=9487"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}