GW EMBERS Research Lab

Endocrine, MIS, Breast, and Education Research in Surgery

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


Journal article


E. Toraih, Mahmoud A. AbdAlnaeem, Tanvi Bobba, R. Elshazli, A. Abdelmaksoud, Yaser Y Bashumeel, Abdulrahman Ghaleb, Mohammad H. Hussein, Jessan A. Jishu, S. Noureldine, Emad Kandil
World Journal of Surgical Oncology, 2025

Semantic Scholar DOI PubMedCentral PubMed
Cite

Cite

APA   Click to copy
Toraih, E., AbdAlnaeem, M. A., Bobba, T., Elshazli, R., Abdelmaksoud, A., Bashumeel, Y. Y., … Kandil, E. (2025). The role of thymectomy during parathyroidectomy in multiple endocrine neoplasia type 1-associated hyperparathyroidism: a systematic review and meta-analysis. World Journal of Surgical Oncology.


Chicago/Turabian   Click to copy
Toraih, E., Mahmoud A. AbdAlnaeem, Tanvi Bobba, R. Elshazli, A. Abdelmaksoud, Yaser Y Bashumeel, Abdulrahman Ghaleb, et al. “The Role of Thymectomy during Parathyroidectomy in Multiple Endocrine Neoplasia Type 1-Associated Hyperparathyroidism: a Systematic Review and Meta-Analysis.” World Journal of Surgical Oncology (2025).


MLA   Click to copy
Toraih, E., et al. “The Role of Thymectomy during Parathyroidectomy in Multiple Endocrine Neoplasia Type 1-Associated Hyperparathyroidism: a Systematic Review and Meta-Analysis.” World Journal of Surgical Oncology, 2025.


BibTeX   Click to copy

@article{e2025a,
  title = {The role of thymectomy during parathyroidectomy in multiple endocrine neoplasia type 1-associated hyperparathyroidism: a systematic review and meta-analysis},
  year = {2025},
  journal = {World Journal of Surgical Oncology},
  author = {Toraih, E. and AbdAlnaeem, Mahmoud A. and Bobba, Tanvi and Elshazli, R. and Abdelmaksoud, A. and Bashumeel, Yaser Y and Ghaleb, Abdulrahman and Hussein, Mohammad H. and Jishu, Jessan A. and Noureldine, S. and Kandil, Emad}
}

Abstract

Current 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. A 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. TCT 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. Concomitant 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.