Leong Eugene Kwong Fei, See Ray Meng, Lin Zhimin, Chin Meredeth Choon Siang, Chew Joshua Wei Yang, Ngiam Kee Yuan, Lee James Wai Kit
Division of General Surgery (Endocrine & Thyroid Surgery), Department of Surgery, National University Hospital, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Front Endocrinol (Lausanne). 2025 Jun 4;16:1562493. doi: 10.3389/fendo.2025.1562493. eCollection 2025.
The purpose of this study is to evaluate the use of percutaneous ethanol and calcitriol injection therapy for hyperparathyroidism (HPT), while taking into account the efficacy, safety and feasibility as an ambulatory procedure alternative to surgical parathyroidectomy.
We included nine patients who underwent percutaneous injection therapy for HPT from January 2018 to December 2021 in our institution. They were followed up from date of first percutaneous injection until death or October 2022 (mean duration of 9.0 months).
Four patients underwent percutaneous ethanol injection therapy (PEIT) (mean age 61.0 [31-89] years old), while the remaining five underwent percutaneous calcitriol therapy (PCIT) (mean age 62.6 [35-91] years old). The analyzed parameters are age, BMI, serum turn over markers as iPTH, Ca, alkaline phosphatase and vitamin D. Two out of the four patients undergoing PEIT had a successful outcome, although one needed to continue cinacalcet due to persistent serum calcium levels. Three out of five PCIT patients in our series had successful procedure, although one subsequently developed refractory disease.
PEIT and PCIT are feasible and safe therapeutic alternatives to surgical parathyroidectomy in HPT refractory to medical treatment, with postulated benefits of decreased costs and being an outpatient procedure. However, further studies are necessary to evaluate the efficacy and cost-effectiveness with these techniques prior to widespread adoption.
本研究的目的是评估经皮乙醇和骨化三醇注射疗法治疗甲状旁腺功能亢进症（HPT）的效果，同时考虑其作为门诊手术替代甲状旁腺切除术的有效性、安全性和可行性。
我们纳入了2018年1月至2021年12月在我院接受经皮注射治疗HPT的9例患者。从首次经皮注射之日起对他们进行随访，直至死亡或2022年10月（平均随访时间为9.0个月）。
4例患者接受了经皮乙醇注射疗法（PEIT）（平均年龄61.0[31 - 89]岁），其余5例接受了经皮骨化三醇疗法（PCIT）（平均年龄62.6[35 - 91]岁）。分析的参数包括年龄、体重指数、血清转换标志物，如iPTH、钙、碱性磷酸酶和维生素D。接受PEIT的4例患者中有2例治疗成功，尽管有1例由于血清钙水平持续升高需要继续服用西那卡塞。我们系列中的5例PCIT患者中有3例治疗成功，尽管有1例随后发展为难治性疾病。
对于药物治疗无效的HPT患者，PEIT和PCIT是替代甲状旁腺切除术的可行且安全的治疗方法，具有降低成本和门诊手术的假定优势。然而，在广泛应用之前，有必要进一步研究评估这些技术的疗效和成本效益。
