Faculty Collaboration Database

Surgical treatment of hyperparathyroidism in patients with multiple endocrine neoplasia type 1. Arch Surg 2005 Apr;140(4):374-82

Date

04/22/2005

Pubmed ID

15841561

DOI

10.1001/archsurg.140.4.374

Scopus ID

2-s2.0-16844369155 (requires institutional sign-in at Scopus site)   69 Citations

Abstract

HYPOTHESIS: Three-gland parathyroidectomy with trans-cervical thymectomy and cryopreservation is the preferred initial surgical approach for hyperparathyroidism (HPT) in patients with multiple endocrine neoplasia type 1.

DESIGN: Retrospective cohort study.

SETTING: Tertiary referral center.

PATIENTS: Thirty-seven patients with multiple endocrine neoplasia type 1 who underwent 1 or more surgical procedures for HPT from January 1, 1973 to April 30, 2004.

RESULTS: At initial parathyroid surgery, 16 (43%) of 37 patients had fewer than 3 parathyroid glands resected (group 1); 16 (43%) had at least 3 but fewer than 4 glands (group 2), and 5 (14%), 4 or more glands (group 3). Follow-up of at least 6 months after initial surgery was complete for 31 (84%) of 37 patients.

CONCLUSIONS: Recurrent HPT in patients with multiple endocrine neoplasia type 1 is frequent if fewer than 3 glands are removed at initial parathyroidectomy. Optimal surgical intervention must balance the risk of recurrent hypercalcemia with the morbidity of permanent hypoparathyroidism. Three-gland parathyroidectomy, transcervical thymectomy, and parathyroid cryopreservation constitute our preferred initial surgical procedure.

Author List

Lambert LA, Shapiro SE, Lee JE, Perrier ND, Truong M, Wallace MJ, Hoff AO, Gagel RF, Evans DB

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Female
Humans
Hyperparathyroidism
Male
Middle Aged
Multiple Endocrine Neoplasia Type 1
Parathyroidectomy
Retrospective Studies
Treatment Outcome