{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:23:16Z","timestamp":1791267796277,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2011,6,29]],"date-time":"2011-06-29T00:00:00Z","timestamp":1309305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal surgical approach for patients with primary hyperparathyroidism (pHPT) and multiple endocrine neoplasia 1 (MEN1) is controversial. We sought to determine the optimal type of surgery for pHPT in MEN1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected data on clinical presentation, surgery, and follow\u2010up for MEN1 patients with pHPT at the University Medical Center Utrecht and affiliated hospitals between 1967 and 2008. Furthermore, we performed a systematic review of the literature and meta\u2010analysis. Surgical procedures were classified into less than subtotal (&lt;SPTX) versus subtotal (SPTX) and total parathyroidectomy (TPTX).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty\u2010two patients underwent primary surgery for pHPT, of which 29 had &lt;SPTX, 17 SPTX, and 6 TPTX. Recurrent pHPT was most frequent after SPTX (65%) followed by &lt;SPTX (59%). Persistent disease was most frequent after &lt;SPTX (31%). Time to recurrence was 61\u00a0months longer after SPTX than after &lt;SPTX. Although recurrent pHPT was not seen after TPTX, permanent hypoparathyroidism developed in 67% of these patients. The meta\u2010analysis showed that after SPTX and TPTX, patients had the lowest risk of persistent and recurrent pHPT. TPTX had the highest risk of permanent hypoparathyroidism. Large noncomparative studies showed a low recurrence rate after SPTX and TPTX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We believe that SPTX is the best surgical therapy for pHPT in MEN1. MEN1 patients with pHPT should not be treated with &lt;SPTX because of the unacceptable high rate of recurrent and persistent pHPT. Additionally, a thymectomy should routinely be performed in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-011-1068-9","type":"journal-article","created":{"date-parts":[[2011,6,29]],"date-time":"2011-06-29T10:49:04Z","timestamp":1309344544000},"page":"1993-2005","source":"Crossref","is-referenced-by-count":96,"title":["The Optimal Surgical Treatment for Primary Hyperparathyroidism in MEN1\u00a0Patients: A Systematic Review"],"prefix":"10.1002","volume":"35","author":[{"given":"Jennifer M. J.","family":"Schreinemakers","sequence":"first","affiliation":[{"name":"Department of Surgery University Medical Center Utrecht Heidelberglaan 100 3584CX Utrecht The Netherlands"},{"name":"Department of Surgery Amphia Hospital Breda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina R. C.","family":"Pieterman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anouk","family":"Scholten","sequence":"additional","affiliation":[{"name":"Department of Surgery University Medical Center Utrecht Heidelberglaan 100 3584CX Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno R.","family":"Vriens","sequence":"additional","affiliation":[{"name":"Department of Surgery University Medical Center Utrecht Heidelberglaan 100 3584CX Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerlof D.","family":"Valk","sequence":"additional","affiliation":[{"name":"Department of Endocrinology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inne H. 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