Universidad Peruana Cayetano Heredia

Comparative efficacy of parathyroidectomy and active surveillance in patients with mild primary hyperparathyroidism: a systematic review and meta-analysis

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dc.contributor.author Singh-Ospina, N.
dc.contributor.author Maraka, S.
dc.contributor.author Rodriguez-Gutierrez, R.
dc.contributor.author Espinosa-de-Ycaza, A. E.
dc.contributor.author Jasim, S.
dc.contributor.author Gionfriddo, M.
dc.contributor.author Castaneda-Guarderas, A.
dc.contributor.author Brito, J. P.
dc.contributor.author Al-Nofal, A.
dc.contributor.author Erwin, P.
dc.contributor.author Wermers, R.
dc.contributor.author Montori, V.
dc.date.accessioned 2019-02-06T14:51:44Z
dc.date.available 2019-02-06T14:51:44Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5248
dc.description.abstract Counseling for patients with primary hyperparathyroidism (PHPT) and mild hypercalcemia without indications for surgical intervention requires accurate estimates of the potential benefits of parathyroidectomy. We aim to summarize the available evidence regarding the benefits of parathyroidectomy that patients with mild PHPT without indications for surgery experience compared to observation. We searched multiple databases from inception to August 2015. We included randomized controlled trials (RCT) and observational studies that evaluated changes in bone health, quality of life or neuropsychiatric symptoms, or in the risk of nephrolithiasis, cardiovascular events, or death between patients undergoing parathyroidectomy or active surveillance. Eight studies were eligible. Risk differences were not significant, in part due to lack of events (fractures, nephrolithiasis, cardiovascular events, or deaths). No significant differences were observed across measures of bone health, quality of life, and neuropsychiatric symptoms. A single RCT evaluating bone mineral density (BMD) changes at 5 years found a small statistically significant effect favoring parathyroidectomy. Patients with mild PHPT without indications for surgery experience a limited number of adverse consequences during short-term follow-up limiting our ability to estimate the benefit of surgery during this timeframe. This information is helpful as these patients consider surgery versus active surveillance. Long-term data is warranted to determine who benefits in the long run from surgical intervention and the extent to which this benefit affects outcomes that matter to patients. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartofseries Osteoporosis International
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Bone Density en_US
dc.subject Bone mineral density en_US
dc.subject Hypercalcemia en_US
dc.subject Parathyroidectomy en_US
dc.subject Primary hyperparathyroidism en_US
dc.subject Surveillance en_US
dc.subject Humans en_US
dc.subject Hypercalcemia/complications en_US
dc.subject Hyperparathyroidism, Primary/surgery en_US
dc.subject Observational Studies as Topic en_US
dc.subject Quality of Life en_US
dc.title Comparative efficacy of parathyroidectomy and active surveillance in patients with mild primary hyperparathyroidism: a systematic review and meta-analysis en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.1007/s00198-016-3715-3
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.relation.issn 1433-2965


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