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Ultrasound-Guided Radiofrequency Ablation for the Treatment of Primary Hyperparathyroidism: An Efficacy and Safety Study
Institution:1. School of Medicine, Nankai University, Tianjin, China;2. Department of Ultrasound, The First Medical Center of Chinese People''s Liberation Army General Hospital, Beijing, China;3. Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
Abstract:ObjectiveTo evaluate the efficacy and safety of radiofrequency ablation (RFA) for the treatment of primary hyperparathyroidism (pHPT).MethodsOur study enrolled 25 patients who were treated with RFA for pHPT from September 2015 to January 2020. The serum intact parathyroid hormone (iPTH), calcium, and phosphate levels were tested within 1 week before RFA and at 1 day, 1 month, 3 months, 6 months, and 12 months after ablation. The ablation areas were evaluated using ultrasound at 1, 3, 6, and 12 months after RFA. Postoperative complications, including voice hoarseness, hematoma, postoperative pain, incision infections, hypoparathyroidism, and hypocalcemia, were recorded.ResultsA total of 25 patients with pHPT (mean age, 53.9 ± 10.9 years; 22 women and 3 men) with 29 enlarged parathyroid glands were treated with RFA. Of the 25 patients, 22 were treated in 1 session and 3 were treated in 2 sessions. Serum iPTH and calcium levels decreased significantly on day 1 after RFA (all P < .05). A total of 21 patients had normal levels of serum iPTH and calcium after RFA, with a cure rate of 84%. At the 12-month follow-up, 26 treated parathyroid glands exhibited a volume reduction rate of >70%. There were only a few minor complications, including 4 cases of postoperative pain (in 4 of the 25 patients 16%]) and 1 case of mild postoperative transient hypocalcemia (in 1 of the 25 patients 4%]).ConclusionUltrasound-guided RFA is an effective and safe technique for the treatment of carefully selected patients with pHPT. However, larger sample size and longer follow-up are still needed to further confirm its clinical value.
Keywords:intact parathyroid hormone  parathyroid glands  primary hyperparathyroidism  radiofrequency ablation  ultrasound  CEUS"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"contrast-enhanced ultrasound  iPTH"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"intact parathyroid hormone  MWA"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"microwave ablation  pHPT"}  {"#name":"keyword"  "$":{"id":"kwrd0070"}  "$$":[{"#name":"text"  "_":"primary hyperparathyroidism  RFA"}  {"#name":"keyword"  "$":{"id":"kwrd0080"}  "$$":[{"#name":"text"  "_":"radiofrequency ablation  US"}  {"#name":"keyword"  "$":{"id":"kwrd0090"}  "$$":[{"#name":"text"  "_":"ultrasound  VRR"}  {"#name":"keyword"  "$":{"id":"kwrd0100"}  "$$":[{"#name":"text"  "_":"volume reduction rate
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