Effects of percutaneous ethanol injection therapy on subsequent parathyroidectomy.
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.
Department of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan. a2703180@ms1.mmh.org.tw
Han-Hsiang
HH
Chen
Ming-Tsung
MT
Hsu
Chih-Jen
CJ
Wu
Yu-Wei
YW
Chen
Tsen-Long
TL
Yang
D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D004351:Drug Resistance; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000209:etiology / Q000628:therapy*; D015552:Injections, Intralesional; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D010710:Phosphates / Q000097:blood; D012189:Retrospective Studies; D012997:Solvents / Q000008:administration & dosage*; D016896:Treatment Outcome
D015415:Biomarkers; D010281:Parathyroid Hormone; D010710:Phosphates; D012997:Solvents; D000431:Ethanol; D002118:Calcium