Effects of percutaneous ethanol injection therapy on subsequent parathyroidectomy

Abstract Background Although percutaneous ethanol injection therapy (PEIT) is an alternative to surgery for patients with secondary or tertiary hyperparathyroidism, it also has been conjectured to make subsequent parathyroidectomy more difficult. Methods The records of 37 patients with end-stage ren...

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Bibliographic Details
Published in:The American journal of surgery 2008-08, Vol.196 (2), p.155-159
Main Authors: Chen, Han-Hsiang, M.D, Hsu, Ming-Tsung, M.D, Wu, Chih-Jen, Ph.D, Chen, Yu-Wei, M.D, Yang, Tsen-Long, M.D
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers - blood
Calcium - blood
Drug Resistance
Ethanol - administration & dosage
Female
General aspects
Humans
Hyperparathyroidism, Secondary - etiology
Hyperparathyroidism, Secondary - therapy
Injections, Intralesional
Kidney Failure, Chronic - complications
Male
Medical sciences
Middle Aged
Parathyroid Hormone - blood
Parathyroidectomy
Patients
Percutaneous ethanol injection therapy
Phosphates - blood
Phosphorus
Retrospective Studies
Secondary hyperparathyroidism
Solvents - administration & dosage
Statistical analysis
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of endocrine glands
Tertiary hyperparathyroidism
Treatment Outcome
Ultrasonic imaging
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Summary:Abstract Background Although percutaneous ethanol injection therapy (PEIT) is an alternative to surgery for patients with secondary or tertiary hyperparathyroidism, it also has been conjectured to make subsequent parathyroidectomy more difficult. Methods The records of 37 patients with end-stage renal disease managed between September 2000 and August 2005 were reviewed retrospectively. All patients had hyperparathyroidism intractable to medical treatment, and all eventually underwent parathyroidectomy. Of the 37 patients, 20 initially underwent PEIT, whereas 17 did not. Surgical and biochemical outcomes were compared between the 2 groups. Results i-PTH and biochemical markers before and after surgery did not differ significantly between the 2 groups, nor did the outcome, defined as persistent hypocalcemia, persistent hyperphosphatemia, persistent low or high i-PTH, persistent hoarseness, or residual parathyroid mass. Parathyroidectomy in the PEIT group proceeded smoothly and was not hindered by inflammation or tissue adhesion. Conclusions Using PEIT to treat hyperparathyroidism in patients with end-stage renal disease does not make subsequent parathyroidectomy more difficult.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.06.037