Surgery is a very well established and safe operation for patients who are suffering from benign thyroid nodules that are causing local symptoms or cosmetic distress. Some patients however wish to avoid surgery and others are at higher risk or unsuitable for a surgical procedure. Such patients may wish to consider a minimally invasive approach like thyroid RFA.
When looking at studies which investigate complications after surgery or RFA it is often difficult to make direct comparisons because the patients in these studies may be significantly different. For example the type of disease being treated may not be directly comparable (surgically treated patients may have larger nodules), the experience of those performing the treatments may differ and how the studies report complications may also vary. Very few published studies directly try to compare surgery and RFA
While both procedures are safe, studies show overall complications rates are higher for surgery. Complications such as voice problems are more common after surgery than minimally invasive therapies and there is a slightly higher risk of injury to the nerve supplying the voice box with surgery. Surgery also has a much higher risk (anywhere from 15% – 30%) of causing thyroid underactivity (hypothyroidism) even if only part of the gland is removed. This compares with a 1% risk of hypothyroidism with RFA. There is also a risk of temporary (and much more rarely permanent) injury to the parathyroid glands with surgery. In contrast these very small glands (the size of a grain of rice) which lie under the thyroid gland and regulate blood calcium levels, are rarely if ever injured with RFA. Surgery and RFA both have a very low risk for serious bleeding or infection.
