{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:39:23Z","timestamp":1783618763004,"version":"3.55.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"vor","delay-in-days":306,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Multiple endocrine neoplasia type 1 (MEN1) is a rare syndrome with common presenting signs and symptoms secondary to primary hyperparathyroidism (PHPT), which is managed surgically. Traditionally, either subtotal parathyroidectomy (SPTX) or total parathyroidectomy with autologous transplantation (TPTX) is the approach of choice. However, recent studies showed comparable persistence and recurrence rate in a subset of MEN1 patients (two or more concordant preoperative imaging results) who underwent less than subtotal parathyroidectomy (LSPTX).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>We report a case of patient with PHPT and delayed diagnosis of MEN1, who underwent LSPTX without intraoperative parathyroid hormone (IOPTH) measurement. The approach was chosen based on the preoperative imaging studies. Unfortunately, the PHPT persisted and the patient was reoperated. To further elucidate the issue, a systematic search of the literature was conducted on Cochrane library, PubMed, and Scopus; articles relevant to the case were reviewed. Results are conflicting results with most of the studies showed LSPTX is inferior compared to the other two approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Therefore, given the current body of evidence, we consider that subtotal or total parathyroidectomy is still the preferred surgical approach for the treatment of PHPT in MEN1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Further studies are still needed to see whether LSPTX is comparable to SPTX or TPTX in regards to persistent and recurrent hyperparathyroidism if the conditions are met.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.10.140","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T02:16:17Z","timestamp":1604974577000},"page":"337-340","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Less than subtotal parathyroidectomy in multiple endocrine neoplasia type 1"],"prefix":"10.1097","volume":"77","author":[{"given":"Diani","family":"Kartini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipus","family":"Dasawala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francisca","family":"Ham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-76-20260114","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/jso.20181","article-title":"Multiple endocrine neoplasia type 1","volume":"89","author":"Doherty","year":"2005","journal-title":"J. Surg. Oncol"},{"key":"R2-76-20260114","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.suc.2009.06.016","article-title":"Surgical management of MEN1 and -2: state of the art","volume":"89","author":"\u00c5kerstr\u00f6m","year":"2009","journal-title":"Surg. Clin. N. Am"},{"key":"R3-76-20260114","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.surg.2013.03.004","article-title":"Minimally invasive parathyroidectomy provides a conservative surgical option for multiple endocrine neoplasia type 1-primary hyperparathyroidism","volume":"154","author":"Versnick","year":"2013","journal-title":"Surgery"},{"key":"R4-76-20260114","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.ijsu.2018.10.031","article-title":"The PROCESS 2018 statement: updating consensus preferred reporting of case series in surgery (PROCESS) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"},{"key":"R5-76-20260114","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1046\/j.1365-2796.1998.00274.x","article-title":"Pathology of MEN1: morphology, clinicopathologic correlations and tumour development","volume":"243","author":"Komminoth","year":"1998","journal-title":"J. Intern. Med"},{"key":"R6-76-20260114","doi-asserted-by":"crossref","first-page":"618","DOI":"10.3389\/fendo.2018.00618","article-title":"Intraoperative decision-making and technical aspects of parathyroidectomy in young patients with MEN1 related hyperparathyroidism","volume":"9","author":"Nobecourt","year":"2018","journal-title":"Front. Endocrinol"},{"key":"R7-76-20260114","first-page":"451","article-title":"Hyperparathyroidism","volume":"29","author":"Gopinath","year":"2011","journal-title":"Surgery"},{"key":"R8-76-20260114","doi-asserted-by":"crossref","first-page":"2964","DOI":"10.1007\/s00268-016-3624-9","article-title":"Unilateral clearance for primary hyperparathyroidism in selected patients with multiple endocrine neoplasia type 1","volume":"40","author":"Kluijfhout","year":"2016","journal-title":"World J. Surg"},{"key":"R9-76-20260114","doi-asserted-by":"crossref","first-page":"123","DOI":"10.3389\/fendo.2019.00123","article-title":"Could the less-than subtotal parathyroidectomy be an option for treating young patients with multiple endocrine neoplasia type 1-related hyperparathyroidism?","volume":"10","author":"Montenegro","year":"2019","journal-title":"Front. Endocrinol"},{"key":"R10-76-20260114","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1007\/s00268-011-1068-9","article-title":"The optimal surgical treatment for primary hyperparathyroidism in MEN1 patients: a systematic review","volume":"35","author":"Schreinemakers","year":"2011","journal-title":"World J. Surg"},{"key":"R11-76-20260114","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1002\/bjs.7154","article-title":"Surgery for multiple endocrine neoplasia type 1-associated primary hyperparathyroidism","volume":"97","author":"Waldmann","year":"2010","journal-title":"BJS"},{"key":"R12-76-20260114","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1007\/s00268-013-2054-1","article-title":"Utility of intraoperative parathyroid hormone monitoring in patients with multiple endocrine neoplasia type 1-Associated primary hyperparathyroidism undergoing initial parathyroidectomy","volume":"37","author":"Nilubol","year":"2013","journal-title":"World J. Surg"},{"key":"R13-76-20260114","doi-asserted-by":"crossref","first-page":"S701","DOI":"10.1245\/s10434-016-5467-x","article-title":"Reoperative surgery in patients with multiple endocrine neoplasia type 1 associated primary hyperparathyroidism","volume":"23","author":"Keutgen","year":"2016","journal-title":"Ann. Surg. Oncol"},{"key":"R14-76-20260114","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1210\/jc.2015-3766","article-title":"Impact of delay in diagnosis in outcomes in MEN1: results from the Dutch MEN1 study group","volume":"101","author":"van Leeuwaarde","year":"2016","journal-title":"J. Clin. Endocrinol. 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