Jorge Falco1, Fernando Dip1,2, Pablo Quadri1, Martin de la Fuente1, Marcos Prunello3, Raúl J Rosenthal4. 1. Hospital de Clínicas "José de San Martín", University of Buenos Aires, Buenos Aires, Argentina. 2. Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA. 3. National University of Rosario Santa Fe, Rosario, Argentina. 4. Department of General Surgery and The Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA. rosentr@ccf.org.
Abstract
BACKGROUND: Parathyroid gland (PG) identification during thyroid and parathyroid surgery is challenging. Accidental parathyroidectomy increases the rate of postoperative hypocalcaemia. Recently, autofluorescence with near infrared light (NIRL) has been described for PG visualization. The aim of this study is to analyze the increased rate of visualization of PGs with the use of NIRL compared to white light (WL). MATERIALS AND METHODS: All patients undergoing thyroid and parathyroid surgery were included in this study. PGs were identified with both NIRL and WL by experienced head and neck surgeons. The number of PGs identified with NIRL and WL were compared. The identification of PGs was correlated to age, sex, and histopathological diagnosis. RESULTS: Seventy-four patients were included in the study. The mean age was 48.4 (SD ±13.5) years old. Mean PG fluorescence intensity (47.60) was significantly higher compared to the thyroid gland (22.32) and background (9.27) (p < 0.0001). The mean number of PGs identified with NIRL and WL were 3.7 and 2.5 PG, respectively (p < 0.001). The difference in the number of PGs identified with NIRL and WL and fluorescence intensity was not related to age, sex, or histopathological diagnosis, with the exception of the diagnosis of thyroiditis, in which there was a significant increase in the number of PGs visualized with NIRL (p = 0.026). CONCLUSION: The use of NIRL for PG visualization significantly increased the number of PGs identified during thyroid and parathyroid surgery, and the differences in fluorescent intensity among PGs, thyroid glands, and background were not affected by age, sex, and histopathological diagnosis.
BACKGROUND: Parathyroid gland (PG) identification during thyroid and parathyroid surgery is challenging. Accidental parathyroidectomy increases the rate of postoperative hypocalcaemia. Recently, autofluorescence with near infrared light (NIRL) has been described for PG visualization. The aim of this study is to analyze the increased rate of visualization of PGs with the use of NIRL compared to white light (WL). MATERIALS AND METHODS: All patients undergoing thyroid and parathyroid surgery were included in this study. PGs were identified with both NIRL and WL by experienced head and neck surgeons. The number of PGs identified with NIRL and WL were compared. The identification of PGs was correlated to age, sex, and histopathological diagnosis. RESULTS: Seventy-four patients were included in the study. The mean age was 48.4 (SD ±13.5) years old. Mean PG fluorescence intensity (47.60) was significantly higher compared to the thyroid gland (22.32) and background (9.27) (p < 0.0001). The mean number of PGs identified with NIRL and WL were 3.7 and 2.5 PG, respectively (p < 0.001). The difference in the number of PGs identified with NIRL and WL and fluorescence intensity was not related to age, sex, or histopathological diagnosis, with the exception of the diagnosis of thyroiditis, in which there was a significant increase in the number of PGs visualized with NIRL (p = 0.026). CONCLUSION: The use of NIRL for PG visualization significantly increased the number of PGs identified during thyroid and parathyroid surgery, and the differences in fluorescent intensity among PGs, thyroid glands, and background were not affected by age, sex, and histopathological diagnosis.
Authors: F Pattou; F Combemale; S Fabre; B Carnaille; M Decoulx; J L Wemeau; A Racadot; C Proye Journal: World J Surg Date: 1998-07 Impact factor: 3.352
Authors: Melanie A McWade; Constantine Paras; Lisa M White; John E Phay; Anita Mahadevan-Jansen; James T Broome Journal: Surgery Date: 2013-12 Impact factor: 3.982
Authors: I Gockel; B Jansen-Winkeln; N Holfert; N Rayes; R Thieme; M Maktabi; R Sucher; D Seehofer; M Barberio; M Diana; S M Rabe; M Mehdorn; Y Moulla; S Niebisch; D Branzan; K Rehmet; J P Takoh; T-O Petersen; T Neumuth; A Melzer; C Chalopin; H Köhler Journal: Chirurg Date: 2020-02 Impact factor: 0.955
Authors: Melanie A McWade; Giju Thomas; John Q Nguyen; Melinda E Sanders; Carmen C Solórzano; Anita Mahadevan-Jansen Journal: J Am Coll Surg Date: 2019-02-13 Impact factor: 6.113
Authors: Giju Thomas; Melanie A McWade; John Q Nguyen; Melinda E Sanders; James T Broome; Naira Baregamian; Carmen C Solórzano; Anita Mahadevan-Jansen Journal: Surgery Date: 2018-11-12 Impact factor: 3.982
Authors: Giju Thomas; Melanie A McWade; Constantine Paras; Emmanuel A Mannoh; Melinda E Sanders; Lisa M White; James T Broome; John E Phay; Naira Baregamian; Carmen C Solórzano; Anita Mahadevan-Jansen Journal: Thyroid Date: 2018-09-11 Impact factor: 6.568
Authors: Carmen C Solórzano; Giju Thomas; Eren Berber; Tracy S Wang; Gregory W Randolph; Quan-Yang Duh; Frédéric Triponez Journal: Surgery Date: 2020-11-01 Impact factor: 3.982