Abstract

Purpose: The present systematic review and meta-analysis was designed to evaluate the efficacy and safety of microwave ablation (MWA) treatment for secondary hyperparathyroidism (SHPT).

Materials and methods: The study authors systematically searched the Web of Science, Cochrane Library, PubMed, Embase and Ovid databases for studies published in English prior to 7October 2019. All studies included in the meta-analysis measured levels of parathyroid hormone (PTH), calcium and phosphorus, and included data related to complications following MWA treatment for SHPT.

Results: The meta-analysis ultimately included 233 patients from two retrospective cohort studies and six retrospective self-control studies. Compared to PTH level measurements obtained after MWA, measurements obtained at one day (weighted mean differences (WMD): 890.314, 95% confidence interval (CI): 767.121–1013.506, p < 0.01) , one week (WMD: 860.298, 95% CI: 759.401–961.194, p < 0.01), one month (WMD: 800.846, 95% CI: 687.709–913.983, p < 0.01) and six months (WMD: 860.847, 95% CI: 745.214–976.480, p < 0.01) after MWA were significantly lower. Calcium and phosphorus levels at one day and one week after MWA were also significantly lower than those measured before MWA. After MWA, the incidence of nerve injury was 1.2% (3/233; effect size (ES): 0.022, 95% CI: −0.003–0.048, p < 0.01). After MWA, the incidence of hypocalcemia was 15.8% (37/233; ES: 0.449, 95% CI: 0.341–0.556, p < 0.01).

Conclusion: The preliminary results of this meta-analysis indicate that MWA may be effective and safe in treating patients with SHPT, and that future prospective research and randomized controlled trials (RCT) are necessary.

摘要

目的：本系统综述和荟萃分析旨在评估微波消融（MWA）治疗继发性甲状旁腺功能亢进症（SHPT）的疗效和安全性。

材料和方法：研究作者系统地搜索了Web of Science，Cochrane图书馆，PubMed，Embase和Ovid数据库，以查找2019年10月7日之前以英语发表的研究。所有研究均包括在荟萃分析中测量的甲状旁腺激素（PTH）水平钙和磷，并包括与SHPT的MWA治疗后并发症相关的数据。

结果：荟萃分析最终包括来自两项回顾性队列研究和六项回顾性自我对照研究的233例患者。与MWA后获得的PTH水平测量值相比，一天获得的测量值（加权平均差异（WMD）：890.314，95％置信区间（CI）：767.121–1013.506，p  <0.01），一周（WMD：860.298，95％） CI：759.401–961.194，p  <0.01），一个月（WMD：800.846，95％CI：687.709–913.983，p  <0.01）和六个月（WMD：860.847，95％CI：745.214–976.480，p <0.01）MWA后显着降低。MWA之后1天和1周的钙和磷水平也显着低于MWA之前的钙和磷水平。MWA后，神经损伤的发生率为1.2％（3/233；效应量（ES）：0.022，95％CI：-0.003-0.048，p  <0.01）。MWA后，低钙血症发生率为15.8％（37/233; ES：0.449，95％CI：0.341–0.556，p  <0.01）。

结论：这项荟萃分析的初步结果表明，MWA在治疗SHPT患者方面可能是有效和安全的，并且有必要进行前瞻性研究和随机对照试验（RCT）。