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Percutaneous Ethanol Ablation of Parathyroid Adenoma and Parathyroidectomy Are Comparable
Iraj Heydari1, Sara Golmohammadi2, Mohammad Reza Babaei3
1Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran, iums.ac.ir.
Aim:
To compare ethanol injection of parathyroid adenoma with surgical parathyroidectomy (PTX).
Methods:
A prospective, partially randomized preference clinical trial of two groups assigned to surgical PTX (20 patients) or ethanol injection (PEA) (10 patients). The inequality was due to patient preferences and limitations caused by the coronavirus pandemic.
Results:
Both PEA and PTX resulted in 80% or more of patients having normalized calcium levels after one month. These were sustained through 6 months. A significant proportion of patients after both PEA and PTX had normalized PTH levels after one month (55% and 70%, respectively), which remained unchanged at the 3- and 6-month measurements. After 12 months, calcium and parathyroid hormone levels were lower in the PTX group, while phosphorus levels were higher; however, the differences were not statistically significant. Complications were more common in the PTX group, although the difference was not statistically significant.
Conclusion:
Overall, PEA and PTX have similar outcomes. Although not statistically significant, the PEA of parathyroid adenoma causes a less pronounced effect on calcium and parathyroid hormone levels and has fewer side effects.