Incidence and Management of Complications in Laser Ablation of Benign Thyroid Nodules

Overview

This systematic review and meta-analysis evaluated complications associated with percutaneous laser ablation (LA) for benign solid thyroid nodules (STNs), analyzing 4745 nodules from 38 studies plus institutional data. Overall complication prevalence was 23%, mostly minor (21%), with major complications rare at 2%. Dysphonia and local pain were the most notable side effects, generally transient and manageable.

Background

Minimally invasive treatments such as laser ablation have become valuable alternatives to surgery for symptomatic benign thyroid nodules. LA offers quick feasibility and cost-effectiveness compared to other thermal ablation techniques like radiofrequency and microwave ablation. While efficacy data are abundant, comprehensive safety data on LA complications have been limited. Understanding the prevalence and management of LA-related complications is critical for clinicians performing these procedures.

Data Highlights

Key Findings

• The overall complication rate of LA for benign STNs was 23%, predominantly minor complications (21%).
• Major complications were rare, occurring in approximately 2% of cases.
• Local pain was the most common minor complication, reported in 15% of patients, typically mild to moderate and transient.
• Dysphonia occurred in 2% of cases, mostly transient with only one permanent case reported.
• Use of local anesthesia or conscious sedation was associated with a slightly higher prevalence of dysphonia.
• Most complications were manageable with conservative treatment, including analgesics for pain.

Clinical Implications

Laser ablation is a generally safe and effective minimally invasive option for treating benign solid thyroid nodules, with a low rate of major complications. Clinicians should counsel patients about the possibility of transient local pain and dysphonia, which are usually mild and self-limiting. Appropriate peri-procedural management, including analgesics and careful technique, can minimize adverse effects.

Conclusion

Percutaneous laser ablation for benign noncystic thyroid nodules demonstrates a favorable safety profile with mostly minor, transient complications. Major adverse events are uncommon, supporting LA as a viable and safe therapeutic option.

References

1. Systematic Review and Meta-Analysis, 2024 -- Incidence and Treatment of Complications Associated with Laser Ablation for Noncystic Benign Thyroid Nodules