Long-Term Effectiveness of Ultrasound-Guided Laser Ablation of Hyperfunctioning Parathyroid Adenomas: Present and Future Perspectives

Abstract

Laser ablation produces a transient reduction of serum PTH and calcium levels but not a lasting resolution of hyperparathyroidism. Laser cannot be proposed as the definitive therapy of pHPT. Thus, studies aiming to identify therapeutic algorithms specific for parathyroid glands are needed to verify the utility of laser ablation in pHPT.

Efficacy and its predictor in microwave ablation for severe secondary hyperparathyroidism in patients undergoing haemodialysis

“…Third, the efficacy of ablation was highly dependent on the performer's technique. The efficacy will differ between interventional physicians [13,14]. In this study MWA was performed by a single interventional physician.…”

“…Administration of vitamin D and its analogues is the classical treatment for early SHPT [4][5][6], whereas parathyroidectomy (PTX) is the most common therapy for severe drug-resistant SHPT; PTX significantly decreases the incidence of cardiovascular events and mortality in these patients [7][8][9][10][11]. Thermal ablation including microwave ablation (MWA), radiofrequency ablation (RFA), and laser ablation, a minimally invasive form of treatment, have been used for several tumours including parathyroid adenoma [12][13][14], hepatic, thyroid, and lung cancers [15,16].…”

Microwave ablation vs. parathyroidectomy for secondary hyperparathyroidism in maintenance hemodialysis patients

“…Administration of vitamin D and its analogues is the classical treatment for early SHPT, whereas parathyroidectomy is the standard therapy for severe drug‐resistant SHPT . As a minimally invasive form of treatment, thermal ablation, such as microwave ablation and radiofrequency ablation, has been increasingly used to treat SHPT . Compared with parathyroidectomy, microwave ablation (MWA) offers more advantages including repeated ablation of SHPT in case of recurrence and preserved residual parathyroid tissue to prevent a permanent reduction in levels of intact parathyroid hormone (iPTH) .…”

“…[5][6][7][8] As a minimally invasive form of treatment, thermal ablation, such as microwave ablation and radiofrequency ablation, has been increasingly used to treat SHPT. [9][10][11] Compared with parathyroidectomy, microwave ablation (MWA) offers more advantages including repeated ablation of SHPT in case of recurrence and preserved residual parathyroid tissue to prevent a permanent reduction in levels of intact parathyroid hormone (iPTH). 12,13 However, the efficacy and safety of MWA for refractory secondary SHPT is not conclusive.…”

Efficacy and safety of ultrasound‐guided radiofrequency ablation of hyperplastic parathyroid gland for secondary hyperparathyroidism associated with chronic kidney disease

“…The advantages of thermal ablation include low invasiveness, easy to control, fast recovery, good efficacy, and repeatable use. Nevertheless, previous studies of thermal ablation in parathyroid gland diseases are limited and mainly focus on primary HPT caused by parathyroid gland adenoma . Indeed, radiofrequency ablation (RFA) allows controlling the amount of tissue being ablated, which could address one of the limitations of surgery .…”