Даваа–Баасан 08:30–20:00 · Бямба 09:00–16:00
Now showing 1 - 3 of 3
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Efficacy and Safety of Radiofrequency Ablation Versus Surgery for Thyroid Nodules
    (Mongolian National University of Medical Sciences, 2022-09-30)
    Otgonbayar Setevdorj
    ;
    Bayarmagnai Munkhjargal
    ;
    Ishdorj Tsedenish
    ;
    ;
    Objectives: To assess the efficacy and safety of radiofrequency (RF) ablation versus surgery for benign thyroid nodules for 24 months period. Methods: From January 2019 to January 2021, 200 patients with nodular goiters who underwent surgery (group A) and 183 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18 g internally cooled electrode were used. We compared the 2 groups in terms of efficacy, and safety during a 2-year follow-up. Results: Nodule type did not differ between groups, although in total 60.1 % were solid, 31.3 % were mixed, and 8.6 % were cystic. However, the number of nodules, median volume before surgery, and diameter of the nodule differed significantly. The median volume reduction was 34.6 % at 1 month, 56.1 % at 3 months, 70.6 % at 6 months, 73.9 % at 12 months, and 74.9 % at 24 months. Any volume reduction between follow-up intervals was statistically significant (p < 0.000). The most patients had no complications. However, surgical patients were more likely to have complications such as bleeding, hoarseness, and infection (14.5 %) than the RFA group (1.6 %). Conclusion: Surgical resection and radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Efficacy and Safety of Radiofrequency Ablation for Benign Thyroid Nodules: Initial Mongolian Experience
    (Mongolian National University of Medical Sciences, 2022-04-01)
    Otgonbayar Setevdorj
    ;
    Bayarmagnai Munkhjargal
    ;
    Ishdorj Tsedenish
    ;
    ;
    Objectives: To assess the efficacy and safety of thyroid radiofrequency (RF) ablation for benign thyroid nodules for a 24 months period. Methods: From 2019 to 2021, 485 nodules were from 183 patients (mean age 47.7 ± 11.2) who met eligibility criteria were enrolled from participants. At pre-ablation, the median volume was 0.371 mL (CI 95 %; 0.289 - 0.513). For 1, 3, 6, 12 and 24 months after treatment, 485 lesions, consisting of 258 (27 %) solid, 108 (11.3 %) predominantly solid, 47 (4.9 %) cystic, 25 (2.6 %) predominantly cystic and 47 (4.9 %) sponge were followed. RFA treatment was performed using two standard techniques (trans isthmic and moving-shot) and an RFA V-1000 cooling system. For 24 months, nodule size reduction was assessed. Results: At pre-ablation, the median volume was 0.371 mL (CI 95 % 0.289 - 0.513). For 1, 3, 6, 12 and 24 months after treatment, median volume reduction was 0.263 (CI 95 %; 0.205 - 0.325 p < 0.000), 0.163 (CI 95 %; 0.124 - 0.218 p < 0.000), 0.153 (CI 95 %; 0.074 - 0.194 p < 0.000), 0.148 (CI 95 %; 0.046 - 0.150 p < 0.000), and 0.062 (CI 95 %; 0.006 - 0.111 p < 0.000) respectively. Median volume statistically decreased significantly p = 0.000. Both mean symptom and cosmetic scores showed significant improvements (p < 0.001). All complications were also evaluated during the follow-up. Conclusion: Thyroid RF ablation is an effective and safe treatment modality in patients with benign thyroid nodules. RF ablation may be as effective as surgery if it is performed by experienced physicians in optimally selected patients.
  • Some of the metrics are blocked by your 
    Item type:Publication,
    P.389: No difference in recurrent hepatocellular carcinoma rates in liver transplanted patients receiving mTOR inhibitors compared to non-mTOR group.
    (Wolters Kluwer, 2024-09-01)
    Anar Ganbold
    ;
    Margad-Erdene Erdenechuluun
    ;
    Bayarmaa Ochirkhuree
    ;
    Urnultsaikhan Ganbold
    ;
    Ulzii-Orshikh Namkhai
    Introduction: A liver transplantation (LT) is a first line therapeutic choice for patients with hepatocellular carcinoma (HCC). Mammalian Target of Rapamycin (mTOR) inhibitors act as immunosuppressant and indicated against HCC recurrence in LT patients. The efficacy of mTOR inhibitors in preventing HCC recurrence remains contentious. Methods: We retrospectively enrolled 45 patients (average age 50, M/F:29/16) who had a history of HCC at the time of LT operation at a single center (2011-2023) and divided into a mTOR and non-mTOR groups. Initial Alfa-fetoprotein (AFP), Protein induced by vitamin K absence-II (PIVKA-II) levels, contrast-enhanced abdominal computer-assisted tomography (CT) scans were compared to most recent results, explant histology was also assessed for HCC extent. Decision to transplant was made based on Milan criteria. Student t-test was used to determine statistical significance (p<0.05). Results: In the mTOR group (n=23, average age 52.7) there were 2 confirmed HCC recurrences with elevated markers and positive CT scans. In the non-mTOR group (n=22, average age 47.4) there was 1 confirmed case of HCC. A recurrence rate of 6.67% was recorded overall, 8.7% and 4.55% for mTOR and non-mTOR (p=0.28), respectively. All three recurrences were detected within 24 months of the operation. For recurrent HCCs, the average levels of PIVKA-II and AFP were 27010mAU/ml and 2842.7ng/ml, respectively. There was no difference in number and mode of pre-LT bridging therapies (TACE or RFA) with regards to recurrence. There were two cases of elevated PIVKA-II without a radiologic confirmation. Conclusion: Adherence to the Milan criteria and application of pre-LT bridging therapies will keep the recurrence rate below 10%. Any possible recurrence will be diagnosed within 24 months of LT. Administration of mTOR inhibitors can be stopped after 2 years as part of the physician-guided minimization of immune suppression regimen.