PMID- 31626728
OWN - NLM
STAT- MEDLINE
DCOM- 20210416
LR  - 20210416
IS  - 1365-2265 (Electronic)
IS  - 0300-0664 (Linking)
VI  - 92
IP  - 1
DP  - 2020 Jan
TI  - Single gland excision for MEN1-associated primary hyperparathyroidism.
PG  - 63-70
LID - 10.1111/cen.14112 [doi]
AB  - IMPORTANCE: Guidelines advocate subtotal parathyroidectomy (SPTX) or total 
      parathyroidectomy with autotransplantation (TPTX) with bilateral cervical 
      thymectomy for primary hyperparathyroidism (pHPT) associated with multiple 
      endocrine neoplasia type 1 (MEN1). However, both procedures are associated with a 
      significant risk of permanent hypoparathyroidism. OBJECTIVE: The aim of the 
      current study was to compare long-term results of either single gland excision 
      (SGE, 1-2 glands), SPTX and TPTX for the treatment of MEN1-associated pHPT. 
      DESIGN AND SETTING: Data of genetically confirmed MEN1 patients who underwent 
      surgery for pHPT between 1987 and 2017 were retrieved from a prospective database 
      and were retrospectively analysed. RESULTS: Eighty-nine MEN1 patients underwent 
      either TPTX (n = 38, 42.7%), SPTX (n = 23, 25.8%) or SGE (n = 28, 31.5%). The 
      rate of disease persistence after initial surgery was 2.6%, 0% and 14.2% in the 
      TPTX, SPTX and SGE groups, respectively. After median follow-up of 112 (range 
      7-411) months, the rate of recurrent pHPT was significantly higher in the SGE 
      group (n = 19, 21.3%) compared with the TPTX (n = 4, 4.4%, P = .001) and the SPTX 
      (n = 9, 10.1%, P = .03) groups. Analysis of the recurrence-free time among the 
      surgical groups revealed a significant difference (P = .036). The median time to 
      recurrence was significantly shorter after SGE (101, range 3-301 months) than 
      after SPTX (139, range 28-278 months, P = .018) and TPTX (204, range 
      75-396 months, P = .049). Twelve (32%) patients who underwent TPTX developed 
      permanent hypoparathyroidism compared with only 4 (17%, P = .06) in the SPTX and 
      0 in the SGE group (P = .001). CONCLUSION: Given the high rate of postoperative 
      permanent hypoparathyroidism after TPTX and SPTX, SGE is a valid option for the 
      treatment of MEN1-associated pHPT.
CI  - (c) 2019 John Wiley & Sons Ltd.
FAU - Manoharan, Jerena
AU  - Manoharan J
AUID- ORCID: 0000-0003-1611-2712
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps University 
      Marburg, Marburg, Germany.
FAU - Albers, Max B
AU  - Albers MB
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps University 
      Marburg, Marburg, Germany.
FAU - Bollmann, Carmen
AU  - Bollmann C
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps University 
      Marburg, Marburg, Germany.
FAU - Maurer, Elisabeth
AU  - Maurer E
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps University 
      Marburg, Marburg, Germany.
FAU - Mintziras, Ioannis
AU  - Mintziras I
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps University 
      Marburg, Marburg, Germany.
FAU - Wachter, Sabine
AU  - Wachter S
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps University 
      Marburg, Marburg, Germany.
FAU - Bartsch, Detlef K
AU  - Bartsch DK
AD  - Department of Visceral, Thoracic and Vascular Surgery, Philipps University 
      Marburg, Marburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20191112
PL  - England
TA  - Clin Endocrinol (Oxf)
JT  - Clinical endocrinology
JID - 0346653
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism, Primary/*etiology/*surgery
MH  - Hypoparathyroidism/*etiology
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*complications
MH  - Parathyroidectomy/*adverse effects/*methods
MH  - Postoperative Complications/*etiology
MH  - Retrospective Studies
MH  - Thymectomy/adverse effects/methods
MH  - Transplantation, Autologous/adverse effects/methods
MH  - Young Adult
OTO - NOTNLM
OT  - hypocalcemia
OT  - hypoparathyroidism
OT  - laryngeal nerve palsy
OT  - multiple endocrine neoplasia type 1
OT  - primary hyperparathyroidism
OT  - recurrence
OT  - surgery
EDAT- 2019/10/19 06:00
MHDA- 2021/04/17 06:00
CRDT- 2019/10/19 06:00
PHST- 2019/05/21 00:00 [received]
PHST- 2019/10/10 00:00 [revised]
PHST- 2019/10/15 00:00 [accepted]
PHST- 2019/10/19 06:00 [pubmed]
PHST- 2021/04/17 06:00 [medline]
PHST- 2019/10/19 06:00 [entrez]
AID - 10.1111/cen.14112 [doi]
PST - ppublish
SO  - Clin Endocrinol (Oxf). 2020 Jan;92(1):63-70. doi: 10.1111/cen.14112. Epub 2019 
      Nov 12.