Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China.
Department of Pathology, China-Japan Friendship Hospital, Beijing, China.
Int J Hyperthermia. 2023;40(1):2243408. doi: 10.1080/02656736.2023.2243408.
To study the safety of improved hydrodissection based on the periparathyroidal fascial space during microwave ablation (MWA) for secondary hyperparathyroidism (SHPT).
Data from 337 patients (162 males and 175 females; mean age, 50.8 ± 12.8 [range, 16-84] years) who underwent MWA for SHPT were retrospectively reviewed. Among them, 177 patients underwent traditional hydrodissection (traditional group) and 160 patients underwent improved hydrodissection based on periparathyroidal fascial spaces (improved group). Safety enhancement was analyzed by comparing the complications between the two groups. The characteristics of the hydrodissected fascial spaces, complications, and the follow-up results were recorded. The baseline data, clinical parameters, laboratory indices and characteristics of SHPT lesions were analyzed to assess the risk factors associated with hoarseness.
Hydrodissection was successfully performed in all the enrolled patients according to the protocol. Six periparathyroid fascial spaces were hydrodissected, depending on the location of the SHPT lesions. The incidence of hoarseness due to recurrent laryngeal nerve injury, the most common complication of thermal ablation for SHPT lesions, was lower in the improved group than in the traditional group (6.9% vs. 13.0%, = 0.044). The median hoarseness recovery time in the improved group was shorter than that in the traditional group (2 vs. 6 months, < 0.001). There was no difference in technical efficiency between the two groups (improved group vs. traditional group: 75.0% vs. 70.6%; > 0.05).
Compared with traditional hydrodissection, improved hydrodissection based on periparathyroidal fascial spaces could enhance safety during MWA for SHPT.
研究基于甲状旁腺周筋膜间隙的改良水分离在微波消融（MWA）治疗继发性甲状旁腺功能亢进症（SHPT）中的安全性。
回顾性分析了 337 例（男 162 例，女 175 例；平均年龄 50.8±12.8[范围 16-84]岁）接受 MWA 治疗 SHPT 的患者资料。其中 177 例采用传统水分离（传统组），160 例采用基于甲状旁腺周筋膜间隙的改良水分离（改良组）。比较两组并发症，分析安全性提高情况。记录水分离筋膜间隙的特点、并发症及随访结果。分析基线资料、临床参数、实验室指标及 SHPT 病变特征，评估与声音嘶哑相关的危险因素。
所有患者均按方案成功进行水分离。根据 SHPT 病变位置，共分离 6 个甲状旁腺周筋膜间隙。因喉返神经损伤导致的声音嘶哑是 MWA 治疗 SHPT 病变最常见的并发症，改良组的发生率低于传统组（6.9%比 13.0%，=0.044）。改良组声音嘶哑恢复时间中位数短于传统组（2 个月比 6 个月，<0.001）。两组技术效率无差异（改良组比传统组：75.0%比 70.6%，>0.05）。
与传统水分离相比，基于甲状旁腺周筋膜间隙的改良水分离可提高 MWA 治疗 SHPT 的安全性。
