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Full thermal ablation versus partial thermal ablation for secondary hyperparathyroidism: A meta-analysis. | LitMetric

AI Article Synopsis

  • A meta-analysis was conducted to compare the effectiveness and complications of full versus partial thermal ablation treatments for refractory secondary hyperparathyroidism (SHPT), as there was no consensus on the optimal ablation approach.
  • The analysis included four studies with a total of 125 patients, showing that full ablation resulted in significantly lower serum parathyroid hormone (PTH), calcium, and phosphorus levels compared to partial ablation.
  • Although full ablation was more effective in reducing these levels, it did not significantly increase the risk of severe hypocalcemia, suggesting a need for more extensive randomized trials to verify these findings.

Article Abstract

Background: Regarding the thermal ablation treatment of refractory secondary hyperparathyroidism (SHPT), there is no consensus on the ablation range of the hyperplastic parathyroid gland. Therefore, this meta-analysis was conducted to evaluate the efficacy and complications between full and partial thermal ablation in patients with refractory SHPT.

Methods: Databases including PubMed, EMbase, the Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang databases were searched from inception to July 1, 2023. Eligible studies comparing full thermal ablation and partial thermal ablation for SHPT were included. Data were analyzed using Review Manager Version 5.3.

Results: Four studies were included in the meta-analysis. Three cohort studies and one randomized controlled trial involving 62 patients in the full thermal ablation group and 63 patients in the partial thermal ablation group were included. The serum parathyroid hormone (PTH), calcium, and phosphorus levels after full ablation were all lower than those after partial ablation (P < .05). There was no significant difference between the partial and full ablation groups concerning the incidence rate of severe hypocalcemia (P = .09). There was no significant difference between the partial and full ablation groups concerning symptom improvement, including bone joint pain, itching, and myasthenia (P < .05).

Conclusion: Full ablation was superior to partial ablation in terms of reducing PTH, calcium and phosphorus levels. Full ablation might not significantly increase the incidence of severe hypocalcemia. Larger multicentre randomized controlled trials are necessary to confirm the conclusion.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695584PMC
http://dx.doi.org/10.1097/MD.0000000000036422DOI Listing

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