Ultrasound-guided radiofrequency ablation for the treatment of primary hyperparathyroidism: An efficacy and safety study.

Abstract

OBJECTIVE\nTo evaluate the efficacy and safety of radiofrequency ablation (RFA) for the treatment of primary hyperparathyroidism (pHPT).\n\n\nMETHODS\n25 patients who were treated with RFA for pHPT from September 2015 to January 2020 were enrolled in our study. The serum intact parathyroid hormone (iPTH), calcium and phosphate levels were tested within 1 week before RFA and at 1 day, 1 month, 3months, 6months and 12months after ablation. The ablation areas were evaluated by US at 1, 3, 6 and 12 months after RFA. Postoperative complications including voice hoarseness, hematoma, postoperative pain, incision infections, hypoparathyroidism and hypocalcemia were recorded.\n\n\nRESULTS\nA total of 25 pHPT patients (53.9 ± 10.9 years, 22 women and 3 men) with 29 enlarged parathyroid glands were treated by RFA. 22 of them were treated in one session and the other three were treated in two sessions. Serum iPTH and calcium levels decreased significantly at 1 day after RFA (all P < 0.05). 21 patients had normal levels of serum iPTH and calcium after RFA, with a cure rate of 84%. 26 treated parathyroid glands exhibited a volume reduction rate greater than 70% at the 12 months follow-up. There were only some minor complications, including four postoperative pain (4/25, 16%) and one mild postoperative transient hypocalcemia (1/25, 4%).\n\n\nCONCLUSIONS\nUS-guided RFA is an effective and safe technique for the treatment of carefully selected patients with pHPT. Larger sample size and longer follow-up are still need to further confirm its clinical value.