Division of Interventional Ultrasound, Department of Medical Ultrasonics, Foshan First Municipal People's Hospital (The Affiliated Foshan Hospital of Sun Yat-sen University), Foshan, China.
Division of Interventional Ultrasound, Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Int J Hyperthermia. 2020;37(1):245-253. doi: 10.1080/02656736.2020.1734673.
To summarize the published literature on thermal ablation for primary hyperparathyroidism (PHPT) and to evaluate the effectiveness and safety of thermal ablation as a novel treatment strategy. Two authors carried out the literature search using four databases independently, including PubMed, Embase, Cochrane, and Web of Science. The meta-analysis included prospective and retrospective data that compared post-ablative outcomes to pre-ablative values. The primary outcomes were parathyroid hormone (PTH), serum calcium and volume of the parathyroid gland (VPG). From the 184 original articles, five studies (4 retrospective studies and 1 prospective study) examining 84 patients met the inclusion criteria. The meta-analysis showed significant reduction of PTH at 3 (standardized mean difference (SMD) = -1.09, 95% confidence index (CI) = -1.42 to -0.76, < 0.001) and 6 months (SMD = -1.13, 95% CI = -1.46 to -0.80, < 0.001) after thermal ablation. Serum calcium level was significantly reduced at 3 (mean difference (MD) = -0.31, 95% CI = -0.50 to -0.12, = 0.001) and 6 months (MD = -0.31, 95% CI = -0.46 to -0.17, < 0.001) after thermal ablation. There was no significant difference between pre-ablative VPG and that of 6 months after ablation (MD = -0.30, 95% CI = -0.70 to 0.09, = 0.13). The most common complications were transient dysphonia and subcutaneous edema. No major complications or death occurred. Thermal ablation is effective and safe for treatment of PHPT. PTH and calcium levels were reduced significantly at 3 and 6 months after thermal ablation.
总结原发性甲状旁腺功能亢进症（PHPT）热消融的文献，并评估热消融作为一种新的治疗策略的有效性和安全性。两位作者使用四个数据库（PubMed、Embase、Cochrane 和 Web of Science）独立进行文献检索。荟萃分析包括前瞻性和回顾性数据，这些数据将消融后的结果与消融前的数值进行比较。主要结局是甲状旁腺激素（PTH）、血清钙和甲状旁腺体积（VPG）。从最初的 184 篇文章中，有 5 项研究（4 项回顾性研究和 1 项前瞻性研究）共 84 例患者符合纳入标准。荟萃分析显示，热消融后 3 个月（标准化均数差（SMD）=-1.09，95%置信区间（CI）=-1.42 至-0.76， <0.001）和 6 个月（SMD=-1.13，95%CI=-1.46 至-0.80， <0.001）时 PTH 显著降低。热消融后 3 个月（平均差（MD）=-0.31，95%CI=-0.50 至-0.12， = 0.001）和 6 个月（MD=-0.31，95%CI=-0.46 至-0.17， <0.001）时血清钙水平显著降低。热消融前和 6 个月后的 VPG 之间没有显著差异（MD=-0.30，95%CI=-0.70 至 0.09， = 0.13）。最常见的并发症是短暂性声音嘶哑和皮下水肿。没有发生重大并发症或死亡。热消融治疗 PHPT 有效且安全。热消融后 3 个月和 6 个月时，PTH 和钙水平显著降低。
