Comparison Of Efficacy In The Treatment Of Primary Hyperparathyroidism Of Ultrasound-guided Microwave Ablation And The Surgical Procedures

ObjectivesTo assess the efficacy and safety of ultrasound-guided microwave ablation(USG-MWA)and postoperative treatment of primary hyperparathyroidism(PHPT),as well as the factors influencing its prognosis,in order to investigate minimally invasive treatment options suitable for PHPT patients and to provide a theoretical foundation for this protocol.MethodsFrom June 2018 to January 2023,the clinical data of 117 patients with PHPT admitted to Gansu Provincial People’s Hospital were studied retrospectively,and they were divided into ablation and operation groups based on treatment mode.45 patients were included in the ablation group,and their treatment mode was USG-MWA;72 patients were included in the operation group,and their treatment mode was surgical resection.After a year of follow-up,the serum intact parathyroid hormone(iPTH),serum calcium(Ca),serum phosphorus(P),primary lesion volume,and its reduction rate(VRR)were compared between the two groups before and after surgery.The two groups’ postoperative response and recurrence rates were observed,the length of surgery,length of hospital stay,intraoperative blood loss,and postoperative complications were documented,and the pertinent aspects impacting the patients’ prognosis were reviewed.Results1.The ablation and operation groups’ operations went off without a hitch.For 2 hours,1 day,3 days,7 days,1 month,3 months,6 months,and 12 months after surgery,serum iPTH and Ca were significantly lower than before surgery,and the P increased significantly(P<0.05).2.The serum iPTH level decreased significantly in both the ablation and operation groups 2 hours after surgery,with the decrease in the ablation group being(75.12±12.89)%and the decrease in the control group being(89.75±5.64)%,and the decrease in the ablation group being significantly lower than that in the surgery group,with a statistically significant difference(P<0.05),and the iPTH of the two groups tended to be stable after 7 days(P>0.05).3.The clinical cure and non-cure rates in the ablation group at 12 months after surgery were 82.22%and 17.78%,respectively,while the operation group was 81.94%and 18.06%,and the preoperative clinical symptoms of the two groups were relieved to varying degrees after surgery,with no statistically significant difference(P>0.05).4.The average surgery length and hospital stay in the ablation group were significantly shorter than those in the control group(P<0.05),saving patients a significant amount of time.The incidence of common complications such as intraoperative blood loss,postoperative discomfort,postoperative hypoparathyroidism,recurrent laryngeal nerve damage,and hypocalcemia was considerably lower in the two groups than in the control group.5.There was a statistical difference in the preoperative Ca level between patients with postoperative hypocalcemia and patients with normal Ca after surgery(P<0.05)in the observation group,5 patients with postoperative hypocalcemia and 34 patients in the ablation group,while there was a statistical difference between subgroups(P<0.05).Conclusions1.Treatment of PHPT with USG-MWA is comparable to surgical intervention in terms of short-and medium-term outcomes,but its long-term outcomes need further evaluation.2,Compared to surgery,USG-MWA has significant advantages such as fewer complications,and saving patients time and money,and it is an emerging minimally invasive PHPT treatment worthy of clinical application.