Parathyroid gland management using optical technologies during thyroidectomy or parathyroidectomy: A systematic...

Area of Science:

• Surgical Innovation
• Medical Optics
• Endocrinology

Background:

• Parathyroid gland (PG) localization and viability assessment are critical during thyroidectomy and parathyroidectomy.
• Existing methods rely heavily on surgeon's visual identification, which can be challenging.
• Novel optical technologies offer potential to augment surgical visualization and improve outcomes.

Purpose of the Study:

• To systematically review optical technologies for parathyroid gland identification and functional assessment in endocrine surgery.
• To evaluate the feasibility and reported outcomes of various optical methods.
• To identify gaps in current research for clinical implementation.

Main Methods:

• Systematic literature review of MEDLINE and Embase databases.
• Inclusion of studies reporting optical tools for thyroidectomy or parathyroidectomy.
• Qualitative analysis of identified optical techniques, focusing on PG identification, vascularization, and clinical outcomes.

Main Results:

• 47 articles involving 1615 patients were reviewed.
• Autofluorescence and indocyanine green (ICG) imaging are the most reported techniques for PG identification and vascular assessment.
• Most studies are observational, demonstrating feasibility but lacking prospective randomized data.

Conclusions:

• Autofluorescence and ICG imaging show potential for enhancing parathyroid gland visualization during endocrine surgery.
• Further prospective randomized studies are required to confirm the clinical utility and impact of these and other optical methods.
• In vivo validation and correlation with biochemical outcomes are needed for broader clinical adoption.