Less Parathyroid Surgery in 2020: Parathyroid Radiofrequency Ablation RFA of Primary Parathyroid Adenoma: 10 cases

Less Parathyroid Surgery in 2020: Parathyroid Radiofrequency Ablation RFA of Primary Parathyroid Adenoma: 10 cases

Less Parathyroid Surgery in 2020: Parathyroid Radiofrequency Ablation RFA of Primary Parathyroid Adenoma: 10 cases

Less Parathyroid Surgery in 2020: Parathyroid Radiofrequency Ablation RFA of Primary Parathyroid Adenoma:  Report of 10 cases

Dr.Guttler’s comments:

  1. 10 cases with no serious complications ( one transient hypocalcemia).
  2. Use of a very tin #19 gauge electrode and small hot tip in a Korean RF system.
  3. Key component is the use of Dextrose infusion to separate the PTA from the recurrent nerve before the ablation begins. This is called microdissection.
  4. PTH and serum calcium returned to normal at 1-6 months.
  5. Dr Ha staed “RFA might represent an effective and a safe alternative for managing parathyroid adenomas, especially in patients ineligible for surgery”.
  6. I suggest that well evaluated patients with a PTA can be considered for RFA as a first choice over surgery.
  7. Call me at 310-393-8860 or email to thyroid.manager@protonmail.com 
  8. I will be able to tell if the location of the PTA is ideal for RF and if not surgery is still the best treatment for them.
  9. Dr.G. in a picture with Dr HA on my right and Dr. Baek on my left at a national  meeting of the Thyroid Ablation Society.
  10. images

Radiofrequency Ablation of Primary Parathyroid Adenoma:

    • Presentation Speakers / Moderators

    Purpose: To retrospectively evaluate the outcomes of ultrasonography (US)-guided radiofrequency ablation (RFA) of parathyroid adenoma in patients who were ineligible for surgery.

    Materials and Method: Ten parathyroid adenomas (mean diameter, 2.0 cm; range, 1.2-3.8 cm) in nine patients with primary hyperparathyroidism were treated with US-guided RFA. The inclusion criteria were (1) primary hyperparathyroidism, (2) pathologically confirmed parathyroid adenoma on US-guided FNA, and (3) refusal- or ineligibility- for surgery. RFA was performed using a RF generator and 19-gauge internally cooled electrode. The hydrodissection technique using the 5% DW was applied in all patients. The medical records were reviewed and analysed, focusing on the procedural profiles of RFA, symptoms and complications during and after RFA, and changes in hormone levels on follow-up US.

    Results: Before RFA, the mean nodule volume was 1.3 ± 1.0 mL. The mean PTH level was 121.1 ± 62.2 pg/mL and calcium level was 10.3 ± 0.7 mg/dL. At 1- and 6- month follow-up after RFA, a significant reduction in the mean volume (46.2% and 92.4 %, respectively) was noted and eight ablation zones (8/10, 80.0%) near completely disappeared (<=0.1mL). The mean PTH level was decreased to the normal range (86.5 ± 55.7 pg/mL) at 1-month follow-up and were  decreased at 6-month follow-up in 8 patients (61.7 ± 33.3 pg/mL). The mean calcium level was decreased to 8.9 ± 0.4 mg/dL at last follow-up. There was one minor complication (transient hypocalcemia) after the treatment.

    Conclusion:  RFA might represent an effective and a safe alternative for managing parathyroid adenomas, especialy in patients ineligible for surgery.

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