PMID- 16378158
OWN - NLM
STAT- MEDLINE
DCOM- 20060420
LR  - 20220318
IS  - 1068-9265 (Print)
IS  - 1068-9265 (Linking)
VI  - 13
IP  - 1
DP  - 2006 Jan
TI  - Primary hyperparathyroidism in multiple endocrine neoplasia type 1: 
      individualized management with low recurrence rates.
PG  - 103-9
AB  - BACKGROUND: To evaluate the outcomes in different surgical modalities for primary 
      hyperparathyroidism in multiple endocrine neoplasia type 1 (MEN1) patients, 
      intraoperative findings from a single surgeon were studied to investigate a 
      potentially improved modality of parathyroidectomy (PTx). METHODS: All 22 
      patients had PTx by a single surgeon in the past 21 years. Three modalities of 
      PTx were used, depending on the operative findings, after all parathyroids and 
      the thymus were identified. If fewer than three glands were enlarged, selective 
      removal of the enlarged glands with or without biopsy of a normal-appearing gland 
      was performed (selective PTx); if all glands were enlarged, either a subtotal PTx 
      leaving a 50-mg remnant in situ or a total PTx with autotransplantation (TPTx + 
      AT) was performed. RESULTS: There were 7 men and 15 women, aged 22 to 67 years 
      (average, 43 years). Sixteen had familial and six had sporadic MEN1. They 
      underwent 23 operations, including 11 selective PTx, 6 subtotal PTx, and 6 TPTx + 
      AT. On follow-up for 1 to 19 years, only one patient (4.6%) had recurrent 
      hyperparathyroidism 5.5 years after subtotal PTx. Others had either normocalcemia 
      (n = 14; 63.6%) or hypocalcemia (n = 7; 31.8%). Those who had either a subtotal 
      PTx or TPTx + AT had a significantly higher rate of postoperative hypocalcemia 
      than those who had a selective PTx (9.9% vs. 54.5%; P = .032; Fisher's exact 
      test). CONCLUSIONS: Primary hyperparathyroidism in our MEN1 patients was less 
      aggressive than that reported in the literature. Selective PTx according to the 
      intraoperative findings achieved optimal outcomes.
FAU - Lee, Chen-Hsen
AU  - Lee CH
AD  - Department of Surgery, Taipei-Veterans General Hospital, 201, Sec. 2, Shih-Pai 
      Rd, Taipei, Taiwan. chlee@vghtpe.gov.tw
FAU - Tseng, Ling-Ming
AU  - Tseng LM
FAU - Chen, Jui-Yu
AU  - Chen JY
FAU - Hsiao, Hsin-Yun
AU  - Hsiao HY
FAU - Yang, An-Hang
AU  - Yang AH
LA  - eng
PT  - Journal Article
DEP - 20060101
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism/etiology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*complications
MH  - Recurrence
MH  - Treatment Outcome
EDAT- 2005/12/27 09:00
MHDA- 2006/04/21 09:00
CRDT- 2005/12/27 09:00
PHST- 2004/12/10 00:00 [received]
PHST- 2005/08/02 00:00 [accepted]
PHST- 2005/12/27 09:00 [pubmed]
PHST- 2006/04/21 09:00 [medline]
PHST- 2005/12/27 09:00 [entrez]
AID - 10.1245/ASO.2006.12.009 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2006 Jan;13(1):103-9. doi: 10.1245/ASO.2006.12.009. Epub 2006 Jan 
      1.