{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:17:07Z","timestamp":1790605027578,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thermal ablation is increasingly used for selected benign and low\u2010risk thyroid nodules, yet some patients still require thyroidectomy for regrowth, persistent symptoms, or new oncologic concern. The surgical and pathological impact of ablation\u2010induced remodeling remains incompletely defined. We aimed to characterize postablation thyroidectomy outcomes and identify histological correlates of perioperative morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center retrospective cohort study of patients undergoing thyroidectomy after radiofrequency or ethanol ablation (2021\u20132025). Clinical and ablation\u2010related variables were collected, and intraoperative neuromonitoring was routinely used. Primary outcomes were recurrent laryngeal nerve (RLN) palsy, reoperative hematoma, and hypoparathyroidism. Surgical specimens underwent blinded dual\u2010pathologist assessment with semiquantitative scoring of sclerosis, necrosis, and residual viability, from which a maturation index was derived. Associations with complications were analyzed using nonparametric methods. Outcomes were descriptively compared with a contemporaneous nonablated cohort for contextual purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010one patients were included. Postoperative complications occurred in 22.6% of ablated cases. Histological analysis demonstrated moderate sclerosis (19.2%), necrosis (14.6%), and high residual viability (66.1%), with frequent pericapsular inflammatory changes and preserved capsule integrity. Sclerosis was the only parameter significantly associated with postoperative complications (30.0% vs. 16.9% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.008), whereas nodule size, ablation\u2010to\u2010surgery interval, and incidental carcinoma were not predictive. The maturation index increased with time after ablation but did not discriminate complication risk. Exploratory fibrosis\u2010weighted metrics suggested potential risk thresholds, although these findings remain hypothesis\u2010generating given the limited sample size.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Thyroidectomy after prior ablation is feasible in experienced centers but may be technically demanding and associated with modestly increased procedural complexity. Mature sclerosis represents the principal histological correlate of perioperative morbidity, linking fibrotic remodeling to operative risk. These findings support centralization of postablation thyroid surgery in high\u2010volume units with routine neuromonitoring and specialized pathology and highlight the need for larger prospective studies to validate fibrosis\u2010based risk stratification tools.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70300","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:19:43Z","timestamp":1772990383000},"page":"914-923","source":"Crossref","is-referenced-by-count":3,"title":["Fibrosis\u2010Driven Surgical Risk After Thyroid Nodule Ablation: Quantitative Clinicopathological Determinants of Complications in Post\u2010Ablative Thyroidectomy\u2014A Retrospective Cohort Study"],"prefix":"10.1002","volume":"50","author":[{"given":"Daqi","family":"Zhang","sequence":"first","affiliation":[{"name":"Division of Thyroid Surgery China\u2010Japan Union Hospital of Jilin University Jilin Provincial Key Laboratory of Thyroid Disease Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma  Changchun Jilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvino","family":"Boero","sequence":"additional","affiliation":[{"name":"Division of General Surgery Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Gazzano","sequence":"additional","affiliation":[{"name":"Pathology Unit IRCCS Istituto Auxologico Italiano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Satta","sequence":"additional","affiliation":[{"name":"Pathology Unit IRCCS Istituto Auxologico Italiano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fugazzola","sequence":"additional","affiliation":[{"name":"Department of Endocrinology ASST Santi Paolo e Carlo  Milan Italy"},{"name":"Department of Health Sciences University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Colombo","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"},{"name":"Division of Endocrinology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3191-4369","authenticated-orcid":false,"given":"Francesco","family":"Brucchi","sequence":"additional","affiliation":[{"name":"Division of General Surgery Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianlorenzo","family":"Dionigi","sequence":"additional","affiliation":[{"name":"Division of General Surgery Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan 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