Safety enhancement of improved hydrodissection for microwave ablation in secondary hyperparathyroidism

Abstract

Objective

To study the safety of improved hydrodissection based on the periparathyroidal fascial space during microwave ablation (MWA) for secondary hyperparathyroidism (SHPT).

Materials and Methods

Data from 337 patients (162 males and 175 females; mean age, 50.8 ± 12.8 [range, 16-84] years) who underwent MWA for SHPT were retrospectively reviewed. Among them, 177 patients underwent traditional hydrodissection (traditional group) and 160 patients underwent improved hydrodissection based on periparathyroidal fascial spaces (improved group). Safety enhancement was analyzed by comparing the complications between the two groups. The characteristics of the hydrodissected fascial spaces, complications, and the follow-up results were recorded. The baseline data, clinical parameters, laboratory indices and characteristics of SHPT lesions were analyzed to assess the risk factors associated with hoarseness.

Results

Hydrodissection was successfully performed in all the enrolled patients according to the protocol. Six periparathyroid fascial spaces were hydrodissected, depending on the location of the SHPT lesions. The incidence of hoarseness due to recurrent laryngeal nerve injury, the most common complication of thermal ablation for SHPT lesions, was lower in the improved group than in the traditional group (6.9% vs. 13.0%, p = 0.044). The median hoarseness recovery time in the improved group was shorter than that in the traditional group (2 vs. 6 months, p < 0.001). There was no difference in technical efficiency between the two groups (improved group vs. traditional group: 75.0% vs. 70.6%; p > 0.05).

Conclusions

Compared with traditional hydrodissection, improved hydrodissection based on periparathyroidal fascial spaces could enhance safety during MWA for SHPT.

Keywords:

• Secondary hyperparathyroidism
• microwave ablation
• fascial space
• hydrodissection

Ethics approval

This retrospective study was approved by the Institutional Review Board of our hospital. Written informed consent was obtained from each patient prior to the ablation. The patients consented to publish their examination results and radiological images anonymously, and the requirement for written informed consent for publication of their data was waived by the ethics committee of China-Japan Friendship Hospital.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Some or all datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was funded by the following funding sources: 1. National High-Level Hospital Clinical Research Funding (2022-NHLHCRF-PY-07) and 2. The National Natural Science Foundation of China (62176268) and 3. Beijing Research Ward Project (2022-YJXBF-04-04).