P.L.A.

P.L.A. (percutaneous ultrasound-guided thermo laser ablation)

P.L.A. is a new minimally invasive surgical methodology developed in the 2000s for the treatment of benign thyroid lesions that consists of the insertion of optical fibers inside the nodule that, by conveying light energy, cause complete necrosis of the injured tissues with subsequent volumetric reduction of the nodule and compression symptoms. 


P.L.A. is an atraumatic outpatient procedure that releases no surgical scar and guarantees volumetric reduction of benign thyroid nodules by 50-85% while proposing improvement in compressive and cosmetic symptoms.


The only limitation of this procedure is that it cannot be applied to cystic nodules or carcinomas. Nodule volume reduction is induced through hyperthermia of the affected tissue with coagulative denaturation and necrosis of proteins that also generates modest charring.


Resorption of the destroyed tissue and subsequent progressive reduction of the nodule takes several months and is maximal at about one year. Today, laser ablation of benign nodules is the main alternative to surgery and is applicable to single or dominant benign solid nodules in the context of a plurinodular goiter.

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P.L.A. inclusion criteria

Based on international guidelines of thyroid nodule management and scientific publications describing current clinical practice, the inclusion criteria for the application of the P.L.A. technique are:

 

  • age of the patient older than 18 years;
  • single or dominant nodule (easily identified clinically and on ultrasonography);
  • solid or predominantly solid nodule either "nonfunctioning" or "functioning";
  • at least two negative cytologies for suspected cancer (THY class 2 for SIA PEC classification; 99.8% VPN), the last one performed not more than six months before treatment.

  • Grounds for exclusion from the procedure

    • Symptoms of local compression (sense of constriction in the throat and / or difficulty in breathing);
    • Aesthetic impairment;
    • Inoperable patients due to anesthesiologic risk (cardiovascular, pulmonary, or renal);
    • Patients who refuse to undergo surgery.
  • P.L.A. session.

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  • ultrasound check

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Benefits for the patient

The advantages of applying P.L.A. are: 

 

  • short treatment time;
  • outpatient procedure;
  • conscious sedation only (no general anesthesia);
  • reduction of compression symptoms with good cosmetic results (no scarring);
  • no impairment of other therapeutic actions;
  • greater than 50% nodule reduction at 12 months after treatment;
  • high volume of predictable coagulation as required in a small organ and in lesions at critical sites.


Contact the endocrine surgeon's office for more information.

For more information about the laser thermoablation technique, contact us

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