Cargando…

Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism

Surgical excision is the preferred treatment for multiple endocrine neoplasia type 1 (MEN1)-related primary hyperparathyroidism (PHPT), although controversy regarding the surgical strategy exists. We retrospectively investigated the short-term outcomes of PHPT by various surgical extents. Thirty-thr...

Descripción completa

Detalles Bibliográficos
Autores principales: Choi, Hye Ryeon, Choi, Sun Hyung, Choi, Soon Min, Kim, Jin Kyong, Lee, Cho Rok, Kang, Sang-Wook, Lee, Jandee, Jeong, Jong Ju, Nam, Kee-Hyun, Chung, Woong Youn, Lee, Seunghyun, Hong, Namki, Rhee, Yumie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326992/
https://www.ncbi.nlm.nih.gov/pubmed/32606444
http://dx.doi.org/10.1038/s41598-020-67424-5
_version_ 1783552447092883456
author Choi, Hye Ryeon
Choi, Sun Hyung
Choi, Soon Min
Kim, Jin Kyong
Lee, Cho Rok
Kang, Sang-Wook
Lee, Jandee
Jeong, Jong Ju
Nam, Kee-Hyun
Chung, Woong Youn
Lee, Seunghyun
Hong, Namki
Rhee, Yumie
author_facet Choi, Hye Ryeon
Choi, Sun Hyung
Choi, Soon Min
Kim, Jin Kyong
Lee, Cho Rok
Kang, Sang-Wook
Lee, Jandee
Jeong, Jong Ju
Nam, Kee-Hyun
Chung, Woong Youn
Lee, Seunghyun
Hong, Namki
Rhee, Yumie
author_sort Choi, Hye Ryeon
collection PubMed
description Surgical excision is the preferred treatment for multiple endocrine neoplasia type 1 (MEN1)-related primary hyperparathyroidism (PHPT), although controversy regarding the surgical strategy exists. We retrospectively investigated the short-term outcomes of PHPT by various surgical extents. Thirty-three patients who underwent parathyroidectomy due to MEN1-related PHPT at Yonsei Severance Hospital between 2005 and 2018 were included (age [mean ± SD], 43.4 ± 14.1 [range, 23–81] years). Total parathyroidectomy with auto-transplantation to the forearm (TPX) was the most common surgical method (17/33), followed by less-than-subtotal parathyroidectomy (LPX; 12/33) and subtotal parathyroidectomy (SPX; 4/33). There was no postoperative persistent hyperparathyroidism. Recurrence was high in the LPX group without significance (1 in TPX, 2 in SPX, and 3 in LPX, p = 0.076). Permanent and transient hypoparathyroidism were more common in TPX (n = 6/17, 35.3%, p = 0.031; n = 4/17, 23.5%, p = 0.154, respectively). Parathyroid venous sampling (PVS) was introduced in 2013 for preoperative localisation of hyperparathyroidism at our hospital; nine among 19 patients operated on after 2013 underwent pre-parathyroidectomy PVS, with various surgical extents, and no permanent hypoparathyroidism (p = 0.033) or post-LPX recurrence was observed. Although TPX with auto-transplantation is the standard surgery for MEN1-related PHPT, surgical extent individualisation is necessary, given the postoperative hypoparathyroidism rate of TPX and feasibility of PVS.
format Online
Article
Text
id pubmed-7326992
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-73269922020-07-01 Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism Choi, Hye Ryeon Choi, Sun Hyung Choi, Soon Min Kim, Jin Kyong Lee, Cho Rok Kang, Sang-Wook Lee, Jandee Jeong, Jong Ju Nam, Kee-Hyun Chung, Woong Youn Lee, Seunghyun Hong, Namki Rhee, Yumie Sci Rep Article Surgical excision is the preferred treatment for multiple endocrine neoplasia type 1 (MEN1)-related primary hyperparathyroidism (PHPT), although controversy regarding the surgical strategy exists. We retrospectively investigated the short-term outcomes of PHPT by various surgical extents. Thirty-three patients who underwent parathyroidectomy due to MEN1-related PHPT at Yonsei Severance Hospital between 2005 and 2018 were included (age [mean ± SD], 43.4 ± 14.1 [range, 23–81] years). Total parathyroidectomy with auto-transplantation to the forearm (TPX) was the most common surgical method (17/33), followed by less-than-subtotal parathyroidectomy (LPX; 12/33) and subtotal parathyroidectomy (SPX; 4/33). There was no postoperative persistent hyperparathyroidism. Recurrence was high in the LPX group without significance (1 in TPX, 2 in SPX, and 3 in LPX, p = 0.076). Permanent and transient hypoparathyroidism were more common in TPX (n = 6/17, 35.3%, p = 0.031; n = 4/17, 23.5%, p = 0.154, respectively). Parathyroid venous sampling (PVS) was introduced in 2013 for preoperative localisation of hyperparathyroidism at our hospital; nine among 19 patients operated on after 2013 underwent pre-parathyroidectomy PVS, with various surgical extents, and no permanent hypoparathyroidism (p = 0.033) or post-LPX recurrence was observed. Although TPX with auto-transplantation is the standard surgery for MEN1-related PHPT, surgical extent individualisation is necessary, given the postoperative hypoparathyroidism rate of TPX and feasibility of PVS. Nature Publishing Group UK 2020-06-30 /pmc/articles/PMC7326992/ /pubmed/32606444 http://dx.doi.org/10.1038/s41598-020-67424-5 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Choi, Hye Ryeon
Choi, Sun Hyung
Choi, Soon Min
Kim, Jin Kyong
Lee, Cho Rok
Kang, Sang-Wook
Lee, Jandee
Jeong, Jong Ju
Nam, Kee-Hyun
Chung, Woong Youn
Lee, Seunghyun
Hong, Namki
Rhee, Yumie
Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism
title Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism
title_full Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism
title_fullStr Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism
title_full_unstemmed Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism
title_short Benefit of diverse surgical approach on short-term outcomes of MEN1-related hyperparathyroidism
title_sort benefit of diverse surgical approach on short-term outcomes of men1-related hyperparathyroidism
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326992/
https://www.ncbi.nlm.nih.gov/pubmed/32606444
http://dx.doi.org/10.1038/s41598-020-67424-5
work_keys_str_mv AT choihyeryeon benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT choisunhyung benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT choisoonmin benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT kimjinkyong benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT leechorok benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT kangsangwook benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT leejandee benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT jeongjongju benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT namkeehyun benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT chungwoongyoun benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT leeseunghyun benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT hongnamki benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism
AT rheeyumie benefitofdiversesurgicalapproachonshorttermoutcomesofmen1relatedhyperparathyroidism