Radiofrequency ablation for patients with recurrent or persistent secondary hyperparathyroidism after parathyroidectomy : initial experience
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
BACKGROUND: Reoperation for recurrent or persistent secondary hyperparathyroidism (SHPT) after parathyroidectomy is challenging due to surgical scars and postoperative adhesions. Therefore, there is an increasing need to develop a new minimally invasive therapy.
OBJECTIVE: To analyze the efficacy of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with recurrent or persistent SHPT after parathyroidectomy.
PATIENTS AND METHODS: From March 2013 to January 2022, 20 enlarged parathyroid glands in 10 patients with recurrent or persistent SHPT were treated with US-guided RFA. The levels of serum intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP), as well as clinical symptoms, were compared before and after RFA. The ablation procedure-related complications were also evaluated. The target range for iPTH levels was approximately 2-9 times the upper limit of normal (130-585 pg/mL).
RESULTS: The mean follow-up time was 49.6 ± 34.5 months (range from 6 to101 months). The levels of serum iPTH, Ca, and P decreased significantly one day post-ablation. Six months after RFA, 70% of patients reached the targets for iPTH, and 50% of patients reached targets at the end of follow-up. Two patients underwent repeat ablation at 9 months and 6 years after RFA, respectively, due to persistently elevated iPTH levels, and both had serum iPTH concentrations in the recommended range at the recent follow-up visit. The patients' clinical symptoms significantly improved after ablation. Major complications after RFA included hoarseness (2/10) and permanent hypoparathyroidism (1/10). Severe hypocalcemia occurred in four patients (4/10) after ablation.
CONCLUSION: US-guided percutaneous RFA for recurrent or persistent SHPT is safe, efficacious, and repeatable, and can significantly improve hyperparathyroidism-related symptoms.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:83 |
|---|---|
| Enthalten in: |
Endocrine - 83(2024), 3 vom: 01. März, Seite 681-690 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Jiang, Tingting [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Calcium |
|---|
| Anmerkungen: |
Date Completed 01.03.2024 Date Revised 15.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s12020-023-03513-5 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM362221170 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM362221170 | ||
| 003 | DE-627 | ||
| 005 | 20240315232743.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s12020-023-03513-5 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1330.xml |
| 035 | |a (DE-627)NLM362221170 | ||
| 035 | |a (NLM)37725290 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Jiang, Tingting |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Radiofrequency ablation for patients with recurrent or persistent secondary hyperparathyroidism after parathyroidectomy |b initial experience |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.03.2024 | ||
| 500 | |a Date Revised 15.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a BACKGROUND: Reoperation for recurrent or persistent secondary hyperparathyroidism (SHPT) after parathyroidectomy is challenging due to surgical scars and postoperative adhesions. Therefore, there is an increasing need to develop a new minimally invasive therapy | ||
| 520 | |a OBJECTIVE: To analyze the efficacy of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with recurrent or persistent SHPT after parathyroidectomy | ||
| 520 | |a PATIENTS AND METHODS: From March 2013 to January 2022, 20 enlarged parathyroid glands in 10 patients with recurrent or persistent SHPT were treated with US-guided RFA. The levels of serum intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP), as well as clinical symptoms, were compared before and after RFA. The ablation procedure-related complications were also evaluated. The target range for iPTH levels was approximately 2-9 times the upper limit of normal (130-585 pg/mL) | ||
| 520 | |a RESULTS: The mean follow-up time was 49.6 ± 34.5 months (range from 6 to101 months). The levels of serum iPTH, Ca, and P decreased significantly one day post-ablation. Six months after RFA, 70% of patients reached the targets for iPTH, and 50% of patients reached targets at the end of follow-up. Two patients underwent repeat ablation at 9 months and 6 years after RFA, respectively, due to persistently elevated iPTH levels, and both had serum iPTH concentrations in the recommended range at the recent follow-up visit. The patients' clinical symptoms significantly improved after ablation. Major complications after RFA included hoarseness (2/10) and permanent hypoparathyroidism (1/10). Severe hypocalcemia occurred in four patients (4/10) after ablation | ||
| 520 | |a CONCLUSION: US-guided percutaneous RFA for recurrent or persistent SHPT is safe, efficacious, and repeatable, and can significantly improve hyperparathyroidism-related symptoms | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Parathyroid gland | |
| 650 | 4 | |a Radiofrequency ablation | |
| 650 | 4 | |a Secondary hyperparathyroidism | |
| 650 | 4 | |a Thermal ablation | |
| 650 | 4 | |a Ultrasound | |
| 650 | 7 | |a Parathyroid Hormone |2 NLM | |
| 650 | 7 | |a Calcium |2 NLM | |
| 650 | 7 | |a SY7Q814VUP |2 NLM | |
| 700 | 1 | |a Deng, Erya |e verfasserin |4 aut | |
| 700 | 1 | |a Chai, Huihui |e verfasserin |4 aut | |
| 700 | 1 | |a Weng, Ning |e verfasserin |4 aut | |
| 700 | 1 | |a He, Hongfeng |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Zhengxian |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Dandan |e verfasserin |4 aut | |
| 700 | 1 | |a Yue, Wenwen |e verfasserin |4 aut | |
| 700 | 1 | |a Peng, Chengzhong |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Hui-Xiong |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Endocrine |d 1995 |g 83(2024), 3 vom: 01. März, Seite 681-690 |w (DE-627)NLM091795540 |x 1559-0100 |7 nnns |
| 773 | 1 | 8 | |g volume:83 |g year:2024 |g number:3 |g day:01 |g month:03 |g pages:681-690 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s12020-023-03513-5 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 83 |j 2024 |e 3 |b 01 |c 03 |h 681-690 | ||