The therapeutic effect of full ablation and partial ablation of parathyroid for secondary hyperparathyroidism：a comparison study / 介入放射学杂志

ABSTRACT

Objective To investigate the curative effect of complete ablation and partial ablation of parathyroid for secondary hyperparathyroidism (SHPT) by using ultrasound-guided radiofrequency ablation (RFA) or microwave ablation (MWA). Methods A total of 26 patients with hyperparathyroidism secondary to uremia, who were admitted to authors’ hospital during the period from October 2012 to September 2013 to receive full ablation (n=11) or partial ablation (n=15) of parathyroid with MWA or RFA and were followed up for at least 9 months after the treatment, were included in this study. The clinical data were retrospectively analyzed. The therapeutic effect and the influence of MWA and RFA on the serum calcium levels were compared between the two ablation methods. Results Analysis of parathyroid hormone (PTH) levels indicated that in full ablation group the postoperative PTH level was gradually decreased , when compared with the preoperative level, until it became stable and maintained the normal level, and no recurrence was observed;in partial ablation group the postoperative PTH level was decreased first with a subsequent rebound about nine months after the treatment, and this PTH level was higher than the PTH level of full ablation group as well as higher than the normal level (P<0.05). On the 15 patients of partial ablation group, recurrence was seen in 5. Analysis of serum calcium levels showed that the postoperative serum calcium level was decreased in both groups, but in partial ablation group the serum calcium levels determined at 3 and 9 months after the treatment were higher than those in full ablation group (P<0.05). In 11 patients of full ablation group, hypocalcemia occurred in 4. Conclusion In treating SHPT, full ablation of parathyroid is not likely to have postoperative relapse, but it might carry the risk of hypocalcemia; while partial ablation of parathyroid is likely to have postoperative relapse, but the serum calcium level can be well controlled. Considering from the view that controlling of the serum calcium level is clinically very important, partial ablation of parathyroid may be more suitable for clinical purpose.