{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:50:32Z","timestamp":1789426232503,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T00:00:00Z","timestamp":1468195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T00:00:00Z","timestamp":1468195200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary hyperparathyroidism is the most common manifestation of multiple endocrine neoplasia type 1 (MEN1). Guidelines advocate subtotal parathyroidectomy (STP) or total parathyroidectomy with autotransplantation due to high prevalence of multiglandular disease; however, both are associated with a significant risk of permanent hypoparathyroidism. More accurate imaging and use of intraoperative PTH levels may allow a less extensive initial parathyroidectomy (unilateral clearance, removing both parathyroids with cervical thymectomy) in selected MEN1 patients with primary hyperparathyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study at a high\u2010volume tertiary medical center including patients with MEN1 and primary hyperparathyroidism, who underwent STP or unilateral clearance as their initial surgery from 1995 to 2015. Unilateral clearance was offered to patients who had concordant sestamibi and ultrasound showing a single enlarged parathyroid gland. For both the groups, we compared rates of persistent\/recurrent disease and permanent hypoparathyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight patients had unilateral clearance and 16 had STP. Subtotal parathyroidectomy patients were younger (37 vs 52 years). One patient in each group had persistent disease. One (13 %) unilateral clearance and five (31 %) STP patients had recurrent hyperparathyroidism after a mean follow\u2010up of 47 and 68\u00a0months (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.62). No unilateral clearance patients and two of 16 SPT patients had permanent hypoparathyroidism (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.54).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Some MEN1 patients with primary hyperparathyroidism who have concordant localizing studies may be selected for unilateral clearance as an alternative to STP. For appropriately selected MEN1 patients, unilateral clearance can achieve similar results as STP and has no risk of permanent hypoparathyroidism, and may facilitate possible future reoperations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-016-3624-9","type":"journal-article","created":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T13:45:02Z","timestamp":1468244702000},"page":"2964-2969","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Unilateral Clearance for Primary Hyperparathyroidism in Selected Patients with Multiple Endocrine Neoplasia Type 1"],"prefix":"10.1002","volume":"40","author":[{"given":"Wouter P.","family":"Kluijfhout","sequence":"first","affiliation":[{"name":"Department of Surgery University of California Mt Zion, 1600 Divisadero Street 94115 San Francisco CA USA"},{"name":"Department of Surgery University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toni","family":"Beninato","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California Mt Zion, 1600 Divisadero Street 94115 San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick Thurston","family":"Drake","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California Mt Zion, 1600 Divisadero Street 94115 San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno R.","family":"Vriens","sequence":"additional","affiliation":[{"name":"Department of Surgery University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Gosnell","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California Mt Zion, 1600 Divisadero Street 94115 San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen T.","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California Mt Zion, 1600 Divisadero Street 94115 San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Insoo","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California Mt Zion, 1600 Divisadero Street 94115 San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chienying","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Endocrinology University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan\u2010Yang","family":"Duh","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California Mt Zion, 1600 Divisadero Street 94115 San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,11]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02934.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.8.777"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010011\u20101068\u20109"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","unstructured":"NilubolN WeinsteinLS SimondsWFet al. 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