Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection

Li, Zhuo; Zhang, Ling; Peng, Li-Li; Yang, Ya; Lu, Hsu Feng; Chen, Dapeng; Li, Wenge; Yu, Ming

doi:10.1080/02656736.2018.1528392

Cited by 28 publications

(26 citation statements)

References 47 publications

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“…The studies covered a period !8 years, from 2009 to 2017. Two were retrospective cohort studies [26,27], and six were retrospective self-control studies [28][29][30][31][32][33]. The mean follow-up period ranged from six to 23 months, and the sample size ranged from 9-56 patients.…”

Section: Discussionmentioning

confidence: 99%

“…There are two main reasons for this result. First, analysis of the eight included studies showed that many patients were not eligible for surgical resection of a recurrence after primary surgery [28,31,33]. These cases are more difficult to perform, so the incidence of complications may be higher.…”

Section: Discussionmentioning

confidence: 99%

“…Four articles reported PTH levels at one week [26,27,29,30] and one month [26,27,29,31] Figure 2(B,C)). Two articles reported PTH measurements obtained 6 months after MWA [29,33]. The heterogeneity among studies was not significant (p ¼ 0.287, I 2 ¼ 11.9%), so the fixed-effects model was used for the analysis.…”

Section: The Change Of Pthmentioning

confidence: 99%

“…The calcium measurements obtained at one week and one month after MWA were significantly lower than measurements obtained before MWA (WMD: 0.227, 95% CI: 0.024-0.429, p ¼ 0.028; WMD: 0.294, 95% CI: 0.043-0.546, p ¼ 0.022; Figure 3(B,C)). Two articles reported the calcium levels at six months after MWA [29,33]. The heterogeneity among studies was significant (p < 0.01, I 2 ¼ 94.4%), so the random-effects model was used for the analysis.…”

Section: The Change Of Calciummentioning

confidence: 99%

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Efficacy and safety of microwave ablation treatment for secondary hyperparathyroidism: systematic review and meta-analysis

Cao

Zhao

Wei

et al. 2020

International Journal of Hyperthermia

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Purpose: The present systematic review and meta-analysis was designed to evaluate the efficacy and safety of microwave ablation (MWA) treatment for secondary hyperparathyroidism (SHPT). Materials and methods: The study authors systematically searched the Web of Science, Cochrane Library, PubMed, Embase and Ovid databases for studies published in English prior to 7October 2019. All studies included in the meta-analysis measured levels of parathyroid hormone (PTH), calcium and phosphorus, and included data related to complications following MWA treatment for SHPT. Results: The meta-analysis ultimately included 233 patients from two retrospective cohort studies and six retrospective self-control studies. Compared to PTH level measurements obtained after MWA, measurements obtained at one day (weighted mean differences (WMD): 890.314, 95% confidence interval (CI): 767.121-1013.506, p < 0.01) , one week (WMD: 860.298, 95% CI: 759.401-961.194, p < 0.01), one month (WMD: 800.846, 95% CI: 687.709-913.983, p < 0.01) and six months (WMD: 860.847, 95% CI: 745.214-976.480, p < 0.01) after MWA were significantly lower. Calcium and phosphorus levels at one day and one week after MWA were also significantly lower than those measured before MWA. After MWA, the incidence of nerve injury was 1.2% (3/233; effect size (ES): 0.022, 95% CI: À0.003-0.048, p < 0.01). After MWA, the incidence of hypocalcemia was 15.8% (37/233; ES: 0.449, 95% CI: 0.341-0.556, p < 0.01). Conclusion: The preliminary results of this meta-analysis indicate that MWA may be effective and safe in treating patients with SHPT, and that future prospective research and randomized controlled trials (RCT) are necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: The Change Of Pthmentioning

confidence: 99%

Section: The Change Of Calciummentioning

confidence: 99%

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Efficacy and safety of microwave ablation treatment for secondary hyperparathyroidism: systematic review and meta-analysis

Cao

Zhao

Wei

et al. 2020

International Journal of Hyperthermia

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“…Parathyroidectomy (PTX) is necessary for SHPT patients who are refractory to medical therapy . Recently, due to minimal injury, an effective decrease in intact parathyroid hormone (iPTH) and good repeatability, ultrasound (US)‐guided percutaneous microwave ablation (MWA) has been gradually accepted in clinical practice …”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Severe Hypocalcemia After US-Guided Percutaneous Microwave Ablation of the Parathyroid Gland in Patients with Secondary Hyperparathyroidism

Wei

Peng

Zhao

et al. 2019

Journal of Bone and Mineral Research

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Our aim was to identify potential risk factors associated with severe hypocalcemia (SH) after microwave ablation (MWA) in patients with secondary hyperparathyroidism (SHPT). This retrospective cross‐sectional study enrolled 204 consecutive patients (with 387 parathyroid glands) who underwent MWA between July 2015 and May 2018. Clinical parameters, laboratory indices, and parathyroid gland characteristics were analyzed to assess risk factors associated with SH after MWA. SH was defined as serum calcium level lower than 1.875 mmol/L (7.5 mg/dL) after MWA. Two models (I and II) for pre‐MWA and post‐MWA prediction were established, respectively. In accordance with the KDIGO guidelines, the target value for intact parathyroid hormone (iPTH) less than 300 pg/mL within 7 days after MWA was considered as a successful procedure. The success rate of MWA was 71.6% (146/204). The incidence of hypocalcemia and SH after MWA was 35.8% and 22.06%, respectively. The pre‐MWA prediction models I and II showed that high pre‐MWA iPTH, a dramatic reduction in iPTH, low pre‐MWA serum calcium, multiple ablated gland, and lack of pruritus symptoms were risk factors for developing SH. The accuracy (82.23% versus 83.25% in models I and II, respectively), sensitivity (34.88% versus 44.19%), specificity (95.45% versus 94.59%), positive predictive value (PPV) (68.18% versus 70.37%), and negative predictive value (NPV) (84% versus 85.37%) of both models were promising. The logistic regression fitting of the nomograms showed high prediction efficiency (0.845 and 0.863). High pre‐MWA iPTH, dramatic reductions in iPTH, low pre‐MWA serum calcium, multiple gland ablation, and no pruritus symptoms were predictors of SH. © 2019 American Society for Bone and Mineral Research.

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Evaluation of efficacy of ultrasound‐guided microwave ablation in primary hyperparathyroidism

Zhang

Gao

Xiao-juan

et al. 2022

J of Clinical Ultrasound

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Purpose: We aimed to evaluate the clinical efficacy and safety of ultrasonographically (US)-guided percutaneous microwave ablation (MWA) in the treatment of primary hyperparathyroidism (PHPT). Methods: A total of 35 patients who received MWA treatment in our hospital between August, 2019 and January, 2021 were retrospectively analyzed. Serum parathyroid hormone (PTH), calcium, phosphorus levels, and improvement in clinical symptoms were recorded before and after MWA. All patients were followed up for 6 months. Paired-sample t-tests and paired sample Wilcoxon signed-rank tests were used to indicate PTH, calcium, and P levels before and after ablation. Postoperative complications were statistically analyzed to evaluate the therapeutic effect of MWA on PHPT patients. Results: A total of 38 parathyroid nodules in 35 PHPT patients were completely ablated at one time. These results indicated that MWA could effectively destroy parathyroid tissue and decrease the concentrations of PTH, calcium, and phosphorus compared with those before MWA, and the effect was sustained. Moreover, MWA improved clinical symptoms, and improved quality of life of patients. None of patients developed tracheal and esophageal injuries, peripheral hematoma, infection, or other serious complications. Conclusion: US-guided MWA has shown to be an effective and safe approach to treat PHPT patients.

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Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection

Abstract: An Yu (2019) Microwave ablation of hyperplastic parathyroid glands is a treatment option for end-stage renal disease patients ineligible for surgical resection,

Cited by 28 publications

References 47 publications

Efficacy and safety of microwave ablation treatment for secondary hyperparathyroidism: systematic review and meta-analysis

Efficacy and safety of microwave ablation treatment for secondary hyperparathyroidism: systematic review and meta-analysis

Risk Factors of Severe Hypocalcemia After US-Guided Percutaneous Microwave Ablation of the Parathyroid Gland in Patients with Secondary Hyperparathyroidism

Evaluation of efficacy of ultrasound‐guided microwave ablation in primary hyperparathyroidism

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