PMID- 20629112
OWN - NLM
STAT- MEDLINE
DCOM- 20100924
LR  - 20191210
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Linking)
VI  - 97
IP  - 10
DP  - 2010 Oct
TI  - Surgery for multiple endocrine neoplasia type 1-associated primary 
      hyperparathyroidism.
PG  - 1528-34
LID - 10.1002/bjs.7154 [doi]
AB  - BACKGROUND: Surgery in patients with multiple endocrine neoplasia type 1 
      (MEN1)-associated primary hyperparathyroidism (pHPT) is difficult as the 
      condition it is caused by asymmetrical multiple gland hyperplasia. It is 
      uncertain which operative procedure provides the best outcome with regard to 
      long-term normocalcaemia. METHODS: All patients who had surgery for genetically 
      confirmed MEN1-associated pHPT between 1987 and 2009 were identified from a 
      prospective database. Clinical data, operative procedures and outcome were 
      analysed retrospectively. RESULTS: A total of 47 patients were identified. 
      Twenty-three patients underwent total parathyroidectomy with thymectomy and 
      autotransplantation (TPTX + AT), 11 patients subtotal parathyroidectomy (3-3.5 
      glands, SPTX) with thymectomy, and 13 patients selective gland excision (fewer 
      than 3 glands, SGE). Rates of persistent disease, recurrent disease and permanent 
      hypoparathyroidism after TPTX + AT were 4 per cent (1 patient), 4 per cent (1 
      patient) and 22 per cent (5 patients) respectively. Respective rates after SPTX 
      were 0 per cent, 18 per cent (2 patients) and 45 per cent (5 patients), which 
      were not statistically different from those following TPTX + AT. SGE resulted in 
      persistent disease in 23 per cent (3 patients) and a significantly higher rate of 
      recurrent disease (46 per cent, 6 patients; P = 0.004 versus TPTX, P = 0.210 
      versus SPTX), but permanent hypoparathyroidism did not occur. CONCLUSION: TPTX + 
      AT and SPTX both seem adequate surgical procedures for the treatment of 
      MEN1-associated pHPT and are associated with fewer recurrences than SGE.
FAU - Waldmann, J
AU  - Waldmann J
AD  - Department of Visceral, Thoracic and Vascular Surgery, University Hospital 
      Giessen and Marburg, Marburg, Germany. jwaldman@med.uni-marburg.de
FAU - Lopez, C L
AU  - Lopez CL
FAU - Langer, P
AU  - Langer P
FAU - Rothmund, M
AU  - Rothmund M
FAU - Bartsch, D K
AU  - Bartsch DK
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
RN  - 0 (Parathyroid Hormone)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Hyperparathyroidism, Primary/etiology/*surgery
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/complications/*surgery
MH  - Parathyroid Hormone/metabolism
MH  - Parathyroidectomy/methods
MH  - Recurrence
MH  - Thymectomy/methods
MH  - Transplantation, Autologous/methods
MH  - Treatment Outcome
EDAT- 2010/07/16 06:00
MHDA- 2010/09/25 06:00
CRDT- 2010/07/15 06:00
PHST- 2010/07/15 06:00 [entrez]
PHST- 2010/07/16 06:00 [pubmed]
PHST- 2010/09/25 06:00 [medline]
AID - 10.1002/bjs.7154 [doi]
PST - ppublish
SO  - Br J Surg. 2010 Oct;97(10):1528-34. doi: 10.1002/bjs.7154.