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


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-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.

Full Length Article:

Endocrinology and Metabolism: Open Access is a peer reviewed journal which focuses on the publication of current research and developments on the endocrine glands and its secretions with their coordination with metabolism and reproduction. Endocrinology and Metabolism: Open Access aims to function as the global face of endocrinology research.

Subject areas: Endocrine glands and hormones, Hormone metabolism, Structure and physiochemical properties, Paediatric Endocrinology, Endocrine pharmacology, Molecular endocrinology, Gastrointestinal and Neuroendocrinology, Comparative Endocrinology, Cardiovascular endocrinology, Reproductive endocrinology, Hormonal receptors Signalling mechanisms, Hormone regulated gene expression, Intracellular steroid and lipid metabolism, Bone and mineral metabolism.

The journal accepts manuscripts in the form of original research article, review article, short communication, case report, letter-to-the-Editor and Editorials for publication in an open access platform. All the articles published in the journal can be accessed online without any subscription charges and will receive the benefit of extensive worldwide visibility.

Submit your manuscript at : or Send as an attachment to:

Media Contact
Eliza Grace
Associate Managing Editor
Endocrinology and Metabolism: Open Access