Evidence map›Paper›PMID 40640826›Full record

SynthesisWorld journal of surgical oncology2025

The role of thymectomy during parathyroidectomy in multiple endocrine neoplasia type 1-associated hyperparathyroidism: a systematic review and meta-analysis.

Eman A Toraih, Mahmoud A AbdAlnaeem, Tanvi Bobba, Rami M Elshazli, Ahmed Abdelmaksoud, Yaser Y Bashumeel, Abdulrahman N Ghaleb, Mohammad H Hussein, Jessan A Jishu, Salem I Noureldine and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Eman A ToraihDepartment of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA, 70112, USA. etoraih@tulane.edu.
Mahmoud A AbdAlnaeemDepartment of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA, 70112, USA.
Tanvi BobbaSchool of Medicine, Tulane University, 1430 Tulane Ave., New Orleans, LA, 70112, USA.
Rami M ElshazliDepartment of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA, 70112, USA.
Ahmed AbdelmaksoudDepartment of Internal Medicine, University of California, Riverside, CA, 92521, USA.
Yaser Y BashumeelDepartment of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA, 70112, USA.
Abdulrahman N GhalebDepartment of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA, 70112, USA.
Mohammad H HusseinOchsner Clinic Foundation, New Orleans, LA, 70112, USA.
Jessan A JishuSchool of Medicine, Tulane University, 1430 Tulane Ave., New Orleans, LA, 70112, USA.
Salem I NoureldineDepartment of Surgery, School of Medicine and Health Sciences, George Washington University, 2300 I St. NW, Washington, DC, 20037, USA.
Emad KandilDepartment of Surgery, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA, 70112, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent guidelines recommend transcervical thymectomy (TCT) during parathyroidectomy (PTX) for Multiple Endocrine Neoplasia Type 1 (MEN1)-associated primary hyperparathyroidism (PHPT) despite limited evidence substantiating efficacy. We aimed to determine the role of TCT in disease control and safety outcomes.

methodsA systematic review and meta-analysis were conducted on comparative observational studies exploring the efficacy of PTX with or without concomitant TCT for managing PHPT in patients with MEN1. Pooled event proportions were estimated using Freeman-Tukey double arcsine transformation method and converted to relative risk. Six studies (n = 306 patients) were included.

resultsTCT showed significantly reduced rates of persistent (relative risk 0.15; 21.9% vs. 3.1%; p < 0.01) and recurrent PHPT (RR 0.34, 43.8% vs. 12.9%; p = 0.004) necessitating re-operation compared to PTX alone, suggesting improved disease control. Interestingly, the addition of TCT reduced rates of transient PHPT (RR 0.07; 9.3% vs. 0%; p < 0.01 and permanent recurrent laryngeal nerve injury (RR 0.32, 3.9% vs. 1.0%; p = 0.04), indicating possible benefits in morbidity.

conclusionsConcomitant TCT may improve the safety and efficacy of PTX in MEN1-associated PHPT by synergistically clearing all cervical disease and minimizing adverse sequelae. Our findings provide further evidence to support existing recommendations for TCT and can guide surgical decision-making.

Indexed as

Hyperparathyroidism, PrimaryMultiple Endocrine Neoplasia Type 1ParathyroidectomyThymectomyHumansPrognosisEndocrine surgeryHypercalcemiaHyperparathyroidismMEN1MorbidityRelapseTranscervical thymectomy

Identifiers

PMID40640826
PMCPMC12243190

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.