PMID- 9484721
OWN - NLM
STAT- MEDLINE
DCOM- 19980304
LR  - 20190704
IS  - 0004-0010 (Print)
IS  - 0004-0010 (Linking)
VI  - 133
IP  - 2
DP  - 1998 Feb
TI  - The outcome of subtotal parathyroidectomy for the treatment of 
      hyperparathyroidism in multiple endocrine neoplasia type 1.
PG  - 126-9
AB  - BACKGROUND: The efficacy of subtotal parathyroidectomy for the treatment of 
      hyperparathyroidism in multiple endocrine neoplasia type 1 (MEN 1) is unclear. 
      The long-term outcome and optimal timing of operation remain controversial. 
      OBJECTIVE: To determine the long-term outcome of parathyroidectomy for primary 
      hyperparathyroidism in the presence of MEN 1. DESIGN: Case series and 
      retrospective analysis. SETTING: Tertiary referral center. PATIENTS: Patients 
      with MEN 1 from 2 families. INTERVENTIONS: Subtotal parathyroidectomy, ie, 
      resection of 3 1/2 parathyroid glands from each patient. MAIN OUTCOME MEASURES: 
      Recurrence of hyperparathyroidism. RESULTS: Thirty-seven patients underwent 
      subtotal parathyroidectomy. Overall, persistent postoperative hypoparathyroidism 
      developed in 24%, normocalcemia was maintained in 46%, and hyperparathyroidism 
      recurred in 30%. However, after adjustment for the duration of follow-up (by 
      using the Kaplan-Meier method), the cumulative recurrence rates for 
      hyperparathyroidism were 15% at 2 years, 23% at 4 years, 55% at 8 years, and 67% 
      after 8 years. Early recurrence of hyperparathyroidism (within 5 years of 
      operation) was less likely to develop in patients in whom ionized calcium levels 
      of 1.00 mmol/L (4.00 mg/dL) or less were achieved during the perioperative period 
      than in patients in whom this degree of hypocalcemia failed to develop (P=.01). 
      CONCLUSIONS: While relatively long periods of disease remission are possible 
      after subtotal parathyroidectomy, our results indicate that recurrent 
      hyperparathyroidism eventually develops in most patients with MEN 1.
FAU - Burgess, J R
AU  - Burgess JR
AD  - Department of Diabetes and Endocrine Services, Royal Hobart Hospital, Australia. 
      jburges@post.office.utas.edu.au
FAU - David, R
AU  - David R
FAU - Parameswaran, V
AU  - Parameswaran V
FAU - Greenaway, T M
AU  - Greenaway TM
FAU - Shepherd, J J
AU  - Shepherd JJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arch Surg
JT  - Archives of surgery (Chicago, Ill. : 1960)
JID - 9716528
RN  - SY7Q814VUP (Calcium)
SB  - IM
MH  - Adult
MH  - Calcium/blood
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism/blood/etiology/*surgery
MH  - Male
MH  - Multiple Endocrine Neoplasia Type 1/blood/*complications
MH  - Parathyroid Neoplasms/blood/*complications
MH  - *Parathyroidectomy/methods
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 1998/03/04 00:00
MHDA- 1998/03/04 00:01
CRDT- 1998/03/04 00:00
PHST- 1998/03/04 00:00 [pubmed]
PHST- 1998/03/04 00:01 [medline]
PHST- 1998/03/04 00:00 [entrez]
AID - 10.1001/archsurg.133.2.126 [doi]
PST - ppublish
SO  - Arch Surg. 1998 Feb;133(2):126-9. doi: 10.1001/archsurg.133.2.126.