Chemical Parathyroidectomy for Recurrence of Secondary Hyperparathyroidism

Giangrande, A; Castiglioni, Alessandro; Solbiati, Luigi; Ballarati, E; Caligara, F

doi:10.1016/s0272-6386(12)80898-5

Cited by 17 publications

(10 citation statements)

References 13 publications

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“…Follow-up to 12 months revealed a persistent reduction in parathyroid hormone concentration as well as a decrease in total and bone alkaline phosphatase. 98 Similar results have been described in patients with primary hyperparathyroidism. 99, 100 Lemmi and colleagues 101 treated both primary and secondary hyperparathyroidism with percutaneous ethanol injection.…”

Section: Parathyroid Glandssupporting

confidence: 74%

Tissue Chemoablation

Rehman

Landman

Sundaram

et al. 2003

Journal of Endourology

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To date, ethanol chemoablation has been shown to be feasible and reproducible only for metastatic hepatic carcinoma. In urology, chemoablation is still very much in the investigational stage for both the prostate and the kidney. A significant drawback is that even in the gel form, the spread of the chemoablative substance through the tissue is irregular and unpredictable. In the future, chemoablation may become a more effective modality by combining it with radiofrequency or other energy sources.

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Section: Parathyroid Glandssupporting

confidence: 74%

Tissue Chemoablation

Rehman

Landman

Sundaram

et al. 2003

Journal of Endourology

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“…The basis of this therapy is that enlarged parathyroid glands with nodular hyperplasia are destroyed selectively by ethanol injection [22]. We recently reported in dialysis patients a significant decrease in PTH, with improvement in serum calcium, phosphate, and Ca × P product.…”

Section: Discussionmentioning

confidence: 99%

Use of Percutaneous Ethanol Injection Therapy for Recurrent Secondary Hyperparathyroidism after Subtotal Parathyroidectomy

Douthat

Cardozo

Garay

et al. 2011

International Journal of Nephrology

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We evaluated the efficacy of percutaneous ethanol injection therapy (PEIT) as a therapeutic option for recurrence of secondary hyperparathyroidism after subtotal parathyroidectomy in ESRD patients. Six patients underwent PEIT. A mean of 1.3 ± 0.8 ethanol injections was performed. Nodular volume was 1.5 ± 1.7 cm3, and 2.8 ± 2.8 cm3 of ethanol was injected per patient. After ethanol injection PTH decreased significantly (1897 ± 754 to 549 ± 863 pg/mL (P < .01)). There was also a reduction in serum calcium, phosphorus and calcium-phosphorus product. A positive and significant correlation was found between nodular volume with ethanol injected and time from parathyroidectomy. Only one patient required hospitalization due to severe hypocalcaemia. In other two cases, local discomfort and temporary mild dysphonia were registered. PEIT is an effective treatment to control recurrences of secondary hyperparathyroidism postsubtotal parathyroidectomy.

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“…During the study period, the overall population showed a significant decrease in the Ca × P product, as well as in serum phosphorus and the parathyroid volume. Considering the broadest evaluation criterion (decrease in PTH levels after PEI to <50%), Giangrande et al [10] reported a 1-year positive response in 73% of the treated patients. Nevertheless, later studies emphasize the importance of decreasing PTH to levels that are considered desirable for patients on dialysis (PTH ≤300 pg/ml).…”

Section: Discussionmentioning

confidence: 99%

“…A good response to treatment (responders) was defined as the decrease in PTH levels to <50% of the baseline value [10, 11], and an optimal response was defined as a decrease in PTH levels to <300 pg/ml [12]. Desirable levels of serum phosphorus and calcium-phosphorous product were <5.5 mg/dl and <55 mg 2 /dl 2 , respectively [13].…”

Section: Methodsmentioning

confidence: 99%

Treatment of Uremic Hyperparathyroidism with Percutaneous Ethanol Injection

Fassi

Lambertini²,

Farias³

et al. 2005

Nephron Clin Pract

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The percutaneous ethanol injection (PEI) with ultrasound guidance has been suggested for the treatment of patients with hyperparathyroidism who are on dialysis, with the aim of selectively treating the parathyroid glands with nodular hyperplasia. We present our experience in 25 patients with chronic renal failure followed during 13.4 ± 10.6 months. A decrease in the levels of parathormone (PTH) (1,236.32 ± 129.8 vs. 721.66 ± 142.24 pg/ml), phosphatemia (6.16 ± 0.35 vs. 4.93 ± 0.36 mg/dl) and calcium-phosphorous product (60.82 ± 3.81 vs. 46.47 ± 3.46 mg²/dl²) was verified. In 56% of patients, PTH levels decreased (>50% of the baseline value) and 36% had final values <300 pg/ml. Patients in whom ultrasound showed a single gland responded better than those with more than one gland (83.3 vs. 30.8% of responders in each group). The procedures performed had a 4.9% complication rate: hematoma, symptomatic hypocalcemia, temporary paresis of the vocal cords. In summary, treatment with PEI is useful for the management of patients with hyperparathyroidism who are on dialysis, and the results achieved are better in patients who have a single gland identified by ultrasonography.

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Chemical Parathyroidectomy for Recurrence of Secondary Hyperparathyroidism

Cited by 17 publications

References 13 publications

Tissue Chemoablation

Tissue Chemoablation

Use of Percutaneous Ethanol Injection Therapy for Recurrent Secondary Hyperparathyroidism after Subtotal Parathyroidectomy

Treatment of Uremic Hyperparathyroidism with Percutaneous Ethanol Injection

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