Efficacy and safety of radiofrequency ablation for primary and secondary hyperparathyroidism with or without previous parathyroidectomy: a retrospective study

医学 继发性甲状旁腺功能亢进 射频消融术 甲状旁腺切除术 原发性甲状旁腺功能亢进 泌尿科 微波消融 甲状旁腺功能亢进 外科 并发症 回顾性队列研究 甲状旁腺激素 烧蚀 胃肠病学 内科学
作者
Chi-Cheng Chen,Hsiu-Ling Chen,Pi-Ling Chiang,Sheng‐Dean Luo,Yen‐Hsiang Chang,Wei‐Chih Chen,Cheng-Kang Wang,An-Ni Lin,Yueh-Sheng Chen,Shun‐Yu Chi,Wei‐Che Lin
出处
期刊:International Journal of Hyperthermia [Informa]
卷期号:39 (1): 907-917 被引量:8
标识
DOI:10.1080/02656736.2022.2097324
摘要

Introduction This study aimed to investigate and compare the therapeutic efficacy and safety of ultrasound-guided radiofrequency ablation (RFA), between primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT) patients, with or without previous parathyroidectomy (PTX).Subjects and Methods A total of 21 patients (7 PHPT, 14 SHPT) underwent RFA for hyperparathyroidism (HPT) at Kaohsiung Chang Gung Memorial Hospital, Taiwan. Five of the 14 SHPT patients had previously received PTX. The laboratory data, volume change of each parathyroid nodule, symptomatic scores, and complications were analyzed and compared between all groups at 1 and 7 days, and at 1, 3, 6, and 12 months after RFA.Results After RFA, the volume reduction ratio (VRR) for all patients at the last follow-up was 93.76%, and clinical symptoms significantly improved. At 12 months, all PHPT patients achieved successful treatment of intact PTH (iPTH). In SHPT patients, the mean iPTH value significantly decreased 1-day post-RFA, subsequently exhibiting a transient rebound which proceeded to decrease, with 57.1% reaching successful treatment standards. SHPT patients with PTX showed a lower complication score, shorter ablation time, higher iPTH baseline and outcomes, and lower VRR, compared to patients without PTX. The serum calcium level significantly decreased to normal range in 85.7% of all patients at 12 months. Severe hypocalcemia occurred in 23.8% at 1 week, and all were corrected with calcium supplements.Conclusions RFA demonstrates a therapeutic efficacy similar to PTX. It can thus be considered an effective alternative treatment for PHPT, SHPT, or post-PTX patients who are unsuitable for another PTX.
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