Optimal extent of initial parathyroid resection in patients with multiple endocrine neoplasia syndrome type 1: A meta-analysis

Background Hyperparathyroidism is an almost universal feature of multiple endocrine neoplasia type 1 syndrome. We present a systematic review and meta-analysis the postoperative outcomes patients undergoing initial operative treatment primary hyperparathyroidism complicating 1. Methods A comprehensive literature search was performed with priori defined exclusion criteria for studies comparing total parathyroidectomy, subtotal less than parathyroidectomy. Results Twenty-one incorporating 1,131 (272 510 349 parathyroidectomy) were identified. Pooled results revealed increased risk long-term hypoparathyroidism in parathyroidectomy (relative 1.61; 95% confidence interval, 1.12?2.31; P = .009) versus those In or comparison group, greater recurrence 1.37; 1.05?1.79; .02), persistence 2.26; 1.49?3.41; .0001), reoperation 2.48; 1.65?3.73; < .0001) noted patients, albeit lesser 0.47; 0.29?0.75; .002). Conclusion Subtotal compares favorably to exhibiting similar rates decreased propensity hypoparathyroidism. The benefit negated by increase recurrence, persistence, reoperation. Future evaluating performance specific phenotypes should be pursued effort delineate patient-tailored, approach that optimizes outcomes.