Alexandre Bellier1, Yann Wazne2, Thibaut Chollier2, Nathalie Sturm3, Philippe Chaffanjon2,4. 1. Clinical Research Department, CIC 1406, INSERM, Grenoble Alpes University, CS 10217, 38043, Grenoble Cedex 09, France. abellier@chu-grenoble.fr. 2. Department of Endocrine Surgery, Grenoble Alpes University Hospital, Grenoble Cedex 09, France. 3. Department of Pathology, Grenoble Alpes University Hospital, Grenoble Cedex 09, France. 4. GIPSA-Lab (UMR 5216), MOVE Department, Grenoble Alpes University, Grenoble Cedex 09, France.
Abstract
BACKGROUND: The aim of this original study was to determine the number of parathyroid glands that can be saved and reimplanted thanks to autofluorescence during thyroid surgery. Preservation of parathyroid function remains challenging during thyroid surgery. The parathyroid glands must be identified and immediately autotransplanted in the case of devascularization. Near-infrared autofluorescence of parathyroid glands has recently been proposed to help surgeons during the dissection. METHODS: A total of 116 thyroid lobectomies were performed on 70 consecutive adult patients. Each lobectomy specimen was scanned in vitro with an autofluorescence imaging device. Every spot of autofluorescence was examined by the surgeon and subsequently the pathologist. The pathologist also performed a complete study of the rest of the lobe. We compared the results of the macroscopic and microscopic diagnoses. RESULTS: We detected 24 fluorescent spots on the specimens: 13 were considered to be parathyroid tissue by the surgeon and 11, non-parathyroid tissue. The pathologist confirmed the surgical diagnosis but also discovered 15 additional parathyroid glands that were hidden. CONCLUSIONS: Autofluorescence imaging of the thyroidectomy specimen with surgical inspection is safe, quick, noninvasive and can help detect the accidental removal of parathyroid glands. About 60% of these glands can be spared and autotransplanted during the surgery.
BACKGROUND: The aim of this original study was to determine the number of parathyroid glands that can be saved and reimplanted thanks to autofluorescence during thyroid surgery. Preservation of parathyroid function remains challenging during thyroid surgery. The parathyroid glands must be identified and immediately autotransplanted in the case of devascularization. Near-infrared autofluorescence of parathyroid glands has recently been proposed to help surgeons during the dissection. METHODS: A total of 116 thyroid lobectomies were performed on 70 consecutive adult patients. Each lobectomy specimen was scanned in vitro with an autofluorescence imaging device. Every spot of autofluorescence was examined by the surgeon and subsequently the pathologist. The pathologist also performed a complete study of the rest of the lobe. We compared the results of the macroscopic and microscopic diagnoses. RESULTS: We detected 24 fluorescent spots on the specimens: 13 were considered to be parathyroid tissue by the surgeon and 11, non-parathyroid tissue. The pathologist confirmed the surgical diagnosis but also discovered 15 additional parathyroid glands that were hidden. CONCLUSIONS: Autofluorescence imaging of the thyroidectomy specimen with surgical inspection is safe, quick, noninvasive and can help detect the accidental removal of parathyroid glands. About 60% of these glands can be spared and autotransplanted during the surgery.
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