Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/373
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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorMONTENEGRO, Fabio Luiz de Menezes-
dc.contributor.authorLOURENCO JUNIOR, Delmar Muniz-
dc.contributor.authorTAVARES, Marcos Roberto-
dc.contributor.authorARAP, Sergio Samir-
dc.contributor.authorNASCIMENTO JUNIOR, Climerio Pereira-
dc.contributor.authorMASSONI NETO, Ledo Mazzei-
dc.contributor.authorD'ALESSANDRO, Andre-
dc.contributor.authorTOLEDO, Rodrigo Almeida-
dc.contributor.authorCOUTINHO, Flavia Lima-
dc.contributor.authorBRANDAO, Lenine Garcia-
dc.contributor.authorSILVA FILHO, Gilberto de Britto e-
dc.contributor.authorCORDEIRO, Anoi Castro-
dc.contributor.authorTOLEDO, Sergio Pereira Almeida-
dc.date.accessioned2013-07-30T14:39:10Z-
dc.date.available2013-07-30T14:39:10Z-
dc.date.issued2012-
dc.identifier.citationCLINICS, v.67, suppl.1, p.131-139, 2012-
dc.identifier.issn1807-5932-
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/373-
dc.description.abstractMost cases of sporadic primary hyperparathyroidism present disturbances in a single parathyroid gland and the surgery of choice is adenomectomy. Conversely, hyperparathyroidism associated with multiple endocrine neoplasia type 1 (hyperparathyroidism/multiple endocrine neoplasia type 1) is an asynchronic, asymmetrical multiglandular disease and it is surgically approached by either subtotal parathyroidectomy or total parathyroidectomy followed by parathyroid auto-implant to the forearm. In skilful hands, the efficacy of both approaches is similar and both should be complemented by prophylactic thymectomy. In a single academic center, 83 cases of hyperparathyroidism/multiple endocrine neoplasia type 1 were operated on from 1987 to 2010 and our first surgical choice was total parathyroidectomy followed by parathyroid auto-implant to the non-dominant forearm and, since 1997, associated transcervical thymectomy to prevent thymic carcinoid. Overall, 40% of patients were given calcium replacement (mean intake 1.6 g/day) during the first months after surgery, and this fell to 28% in patients with longer follow-up. These findings indicate that several months may be needed in order to achieve a proper secretion by the parathyroid auto-implant. Hyperparathyroidism recurrence was observed in up to 15% of cases several years after the initial surgery. Thus, long-term follow-up is recommended for such cases. We conclude that, despite a tendency to subtotal parathyroidectomy worldwide, total parathyroidectomy followed by parathyroid auto-implant is a valid surgical option to treat hyperparathyroidism/multiple endocrine neoplasia type 1. Larger comparative systematic studies are needed to define the best surgical approach to hyperparathyroidism/multiple endocrine neoplasia type 1.-
dc.description.sponsorshipFAPESP [2009/15386-6, 11942/2009]-
dc.description.sponsorshipCNPq [401990/2010-9]-
dc.language.isoeng-
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO-
dc.relation.ispartofClinics-
dc.rightsopenAccess-
dc.subjectHyperparathyroidism-
dc.subjectParathyroidectomy-
dc.subjectMEN1-
dc.subjectParathyroid glands-
dc.subjectParathyroid neoplasms-
dc.subjectHypercalcemia-
dc.subject.otherasymptomatic primary hyperparathyroidism-
dc.subject.other1-associated primary hyperparathyroidism-
dc.subject.other3rd international workshop-
dc.subject.othersubtotal parathyroidectomy-
dc.subject.othertranscervical thymectomy-
dc.subject.otherthymic carcinoids-
dc.subject.othersurgical approach-
dc.subject.othernatural-history-
dc.subject.otheri syndrome-
dc.subject.othersurgery-
dc.titleTotal parathyroidectomy in a large cohort of cases with hyperparathyroidism associated with multiple endocrine neoplasia type 1: experience from a single academic center-
dc.typearticle-
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO-
dc.identifier.doi10.6061/clinics/2012(Sup01)22-
dc.identifier.pmid22584718-
dc.subject.wosMedicine, General & Internal-
dc.type.categoryreview-
dc.type.versionpublishedVersion-
hcfmusp.description.beginpage131-
hcfmusp.description.endpage139-
hcfmusp.description.issuesuppl 1-
hcfmusp.description.volume67-
hcfmusp.origemWOS-
hcfmusp.origem.idWOS:000304082400022-
hcfmusp.origem.id2-s2.0-84863945130-
hcfmusp.origem.idSCIELO:S1807-59322012001300022-
hcfmusp.publisher.citySAO PAULO-
hcfmusp.publisher.countryBRAZIL-
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dc.description.indexMEDLINE-
hcfmusp.remissive.sponsorshipCNPq-
hcfmusp.remissive.sponsorshipFAPESP-
hcfmusp.lim.ref2012-
hcfmusp.citation.scopus20-
hcfmusp.scopus.lastupdate2022-04-29-
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Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/25
LIM/25 - Laboratório de Endocrinologia Celular e Molecular

Artigos e Materiais de Revistas Científicas - LIM/28
LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço


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