PMID- 35767091
OWN - NLM
STAT- MEDLINE
DCOM- 20221005
LR  - 20221118
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 46
IP  - 11
DP  - 2022 Nov
TI  - Less Than Subtotal Parathyroidectomy for Multiple Endocrine Neoplasia Type 1 
      Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis.
PG  - 2666-2675
LID - 10.1007/s00268-022-06633-7 [doi]
AB  - BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1)-associated primary 
      hyperparathyroidism (pHPT) is classically associated with an asymmetric and 
      asynchronous parathyroid involvement. Subtotal parathyroidectomy (STP), which is 
      currently the recommended surgical treatment, carries a high risk of permanent 
      hypoparathyroidism. The results of less than subtotal parathyroidectomy (LSTP) 
      are conflicting, and its place in this setting is still a matter of debate. The 
      aim of this study was to identify the place of LSTP in the surgical management of 
      patients with MEN-associated pHPT. METHODS: A systematic literature review was 
      conducted in accordance with PRISMA and MOOSE guidelines, for studies comparing 
      STP and LSTP for MEN1-associated pHPT. The results of the two techniques, 
      regarding permanent hypoparathyroidism, persistent hyperparathyroidism and 
      recurrent hyperparathyroidism were computed using pairwise random-effect 
      meta-analysis. RESULTS: Twenty-five studies comparing STP and LSTP qualified for 
      inclusion in the quantitative synthesis. In total, 947 patients with 
      MEN1-associated pHPT were allocated to STP (n = 569) or LSTP (n = 378). LSTP 
      reduces the risk of permanent hypoparathyroidism [odds ratio (OR) 0.29, 
      confidence interval (CI) 95% 0.17-0.49)], but exposes to higher rates of 
      persistent hyperparathyroidism [OR 4.60, 95% CI 2.66-7.97]. Rates of recurrent 
      hyperparathyroidism were not significantly different between the two groups [OR 
      1.26, CI 95% 0.83-1.91]. CONCLUSIONS: LSTP should not be abandoned and should be 
      considered as a suitable surgical option for selected patients with 
      MEN1-associated pHPT. The increased risk of persistent hyperparathyroidism could 
      improve with the emergence of more efficient preoperative localization imaging 
      techniques and a more adequate patients selection.
CI  - (c) 2022. The Author(s) under exclusive licence to Societe Internationale de 
      Chirurgie.
FAU - Bouriez, Damien
AU  - Bouriez D
AD  - Digestive and Endocrine Surgery Department, Magellan Center, Bordeaux University 
      Hospital, University of Bordeaux, Bordeaux, France.
FAU - Gronnier, Caroline
AU  - Gronnier C
AD  - Digestive and Endocrine Surgery Department, Magellan Center, Bordeaux University 
      Hospital, University of Bordeaux, Bordeaux, France.
FAU - Haissaguerre, Magalie
AU  - Haissaguerre M
AD  - Endocrinology Department, INSERM Unit 1215, Bordeaux University Hospital, 
      University of Bordeaux, Bordeaux, France.
FAU - Tabarin, Antoine
AU  - Tabarin A
AD  - Endocrinology Department, INSERM Unit 1215, Bordeaux University Hospital, 
      University of Bordeaux, Bordeaux, France.
FAU - Najah, Haythem
AU  - Najah H
AUID- ORCID: 0000-0002-9053-6313
AD  - Digestive and Endocrine Surgery Department, Magellan Center, Bordeaux University 
      Hospital, University of Bordeaux, Bordeaux, France. haythem.najah@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20220629
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
CIN - World J Surg. 2022 Nov;46(11):2676-2677. PMID: 36042033
MH  - Humans
MH  - *Hyperparathyroidism, Primary/complications/surgery
MH  - *Hypoparathyroidism/etiology
MH  - *Multiple Endocrine Neoplasia Type 1/complications/surgery
MH  - Parathyroid Glands
MH  - Parathyroidectomy/adverse effects
EDAT- 2022/06/30 06:00
MHDA- 2022/10/06 06:00
CRDT- 2022/06/29 11:16
PHST- 2022/06/06 00:00 [accepted]
PHST- 2022/06/30 06:00 [pubmed]
PHST- 2022/10/06 06:00 [medline]
PHST- 2022/06/29 11:16 [entrez]
AID - 10.1007/s00268-022-06633-7 [pii]
AID - 10.1007/s00268-022-06633-7 [doi]
PST - ppublish
SO  - World J Surg. 2022 Nov;46(11):2666-2675. doi: 10.1007/s00268-022-06633-7. Epub 
      2022 Jun 29.