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<p>Percutaneous thermal ablation techniques, particularly radiofrequency ablation, are now established minimally invasive options for selected benign thyroid nodules, autonomously functioning thyroid nodules, and specific low-risk papillary thyroid microcarcinomas. However, a non-negligible proportion of patients may subsequently require thyroidectomy because of volume regrowth, persistent compressive symptoms, or renewed oncological suspicion. Recent studies have systematically investigated the outcomes of thyroidectomy after ablation in a high-volume centre, focusing on the relationship between post-ablation fibrotic remodelling and operative risk. Two key messages emerge. First, thyroidectomy after radiofrequency ablation is feasible but technically more demanding than de novo thyroid surgery. Second, mature fibrosis appears to be the main histological determinant of perioperative morbidity, more than nodular size or the ablation-to-surgery interval alone. This commentary discusses these findings from an endocrinological perspective, highlighting their implications for patient selection, pre-procedural counselling, the choice between repeat ablation and surgery, and the need to centralize post-ablation surgical cases in high-volume thyroid centres.</p>

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Fibrosi post-ablazione e rischio chirurgico nella tiroidectomia dopo radiofrequenza: implicazioni per l’endocrinologo clinico

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Francesco Brucchi,
  • Carla Colombo,
  • Luca Persani,
  • Gianlorenzo Dionigi

摘要

Percutaneous thermal ablation techniques, particularly radiofrequency ablation, are now established minimally invasive options for selected benign thyroid nodules, autonomously functioning thyroid nodules, and specific low-risk papillary thyroid microcarcinomas. However, a non-negligible proportion of patients may subsequently require thyroidectomy because of volume regrowth, persistent compressive symptoms, or renewed oncological suspicion. Recent studies have systematically investigated the outcomes of thyroidectomy after ablation in a high-volume centre, focusing on the relationship between post-ablation fibrotic remodelling and operative risk. Two key messages emerge. First, thyroidectomy after radiofrequency ablation is feasible but technically more demanding than de novo thyroid surgery. Second, mature fibrosis appears to be the main histological determinant of perioperative morbidity, more than nodular size or the ablation-to-surgery interval alone. This commentary discusses these findings from an endocrinological perspective, highlighting their implications for patient selection, pre-procedural counselling, the choice between repeat ablation and surgery, and the need to centralize post-ablation surgical cases in high-volume thyroid centres.