Thermal ablation and parathyroidectomy (PTx) both effectively treat secondary hyperparathyroidism (SHPT), according to new research published in the International Journal of Surgery.
In a meta-analysis of 4 cohort studies and 2 randomized controlled trials of 326 total patients, levels of parathyroid hormone, calcium, and phosphorus levels did not differ significantly between PTx and thermal ablation (microwave, radiofrequency, and laser ablation), with mean differences of 58, -0.07, and 0.21, respectively. Compared with PTx, however, thermal ablation significantly increased the risk of hyperparathyroidism persistence and/or recurrence by 4.2-fold and significantly decreased the risk of hypocalcemia by 77%. The 2 procedures did not differ significantly with respect to the risk of hoarseness.
According to Wei Xu, MD, PhD candidate, and colleagues from Wujin People’s Hospital in China, thermal ablation might not completely remove the parathyroid gland because it is a less invasive procedure that is not performed under direct observation.
The authors noted that the biggest advantage of thermal ablation compared with PTx is that it is less invasive. “At present, no definite evidence has proven which method is better concerning efficacy and complications. Our systematic review aimed to appraise the efficacy and complications of the two treatment methods for SHPT.”
Gong L, Tang W, Lu J, Xu W. Thermal ablation versus parathyroidectomy for secondary hyperparathyroidism: A meta-analysis. Int J Surg. 2019;70:13-18. doi:10.1016/j.ijsu.2019.08.004