To investigate the clinical effect of microwave ablation and thyroid lobectomy in small papillary thyroid carcinoma (PTMC) with BRAF^V600E gene wild-type cN0.

A total of 108 patients with BRAF^V600E gene wild-type cN0-PTMC admitted to Huanggang Central Hospital from January 2017 to July 2019 were selected and divided into resection group and ablation group by the random number table method, with 54 patients in each group. Thyroid lobectomy was performed in the resection group and microwave ablation was performed in the ablation group. Perioperative indicators, thyroid function, postoperative complications and follow-up were compared between the two groups.

Compared with the resection group, surgical duration, intraoperative blood loss, VAS score, postoperative hospital stay and hospitalization costs were significantly decreased in the ablation group, and aesthetic satisfaction was higher (t=27.825, 29.693, 10.145, 15.495, 8.152, 12.662, all P<0.01). The postoperative TSH level in ablation group was significantly lower than that before surgery (t=32.457, P<0.001), while the FT3 and FT4 levels had no significant difference compared with that before surgery. The level of TSH in resection group was significantly higher than that before surgery (t=130.517, P<0.001), and the level of FT3 and FT4 was significantly lower than that before surgery (t=28.104, 25.641, both P<0.001). There were statistically significant differences in TSH, FT3 and FT4 levels between the two groups after operation (t=21.022, 6.586, 4.659, all P<0.001). The incidence of total postoperative complications in the ablation group was 7.4%, which was significantly lower than that in the resection group (22.2%) (χ²=4.688, P=0.030). There were significant differences in the volume of lesions between the preoperative and postoperative time points in the ablation group (W=21.052, P<0.001). During the follow-up, no recurrence or distant metastasis was found in both groups.

Compared with thyroidectomy, microwave ablation for BRAF^V600E gene wild-type cN0-PTMC not only has the advantages of minimally invasion, rapid recovery, high aesthetic satisfaction and less complications, but also can better retain thyroid function, with good prognosis and high clinical application value.