Parathyroid Autofluorescence-How Does It Affect Parathyroid and Thyroid Surgery? A 5 Year Experience
Roland Ladurner1, Maximilian Lerchenberger1, Norah Al Arabi1
1Department of Surgery, Ludwig Maximilians University Munich, Innenstadt Medical Campus, Nussbaumstrasse 20, 80336 Munich, Germany.
Molecules (Basel, Switzerland)
|July 25, 2019
Summary
Identifying parathyroid glands using near-infrared autofluorescence during surgery is possible. This technique helps surgeons protect these glands, potentially reducing complications like hypoparathyroidism.
Area of Science:
- Surgical Innovation
- Medical Imaging
- Endocrinology
Background:
- Parathyroid gland injury during thyroid and parathyroid surgery is a frequent issue.
- Postoperative hypoparathyroidism is a significant surgical complication.
Purpose of the Study:
- To evaluate the utility of parathyroid autofluorescence in the near-infrared spectrum for intraoperative gland identification.
- To assess the potential of this technique in preventing parathyroid gland damage and subsequent hypoparathyroidism.
Main Methods:
- Utilized a modified Storz laparoscopic near-infrared/indocyanine green (NIR/ICG) imaging system with a filtered xenon light source (690-790 nm).
- Observed parathyroid autofluorescence at 820 nm, captured in the camera's blue channel.
- Investigated 205 parathyroid glands from 117 patients over a 5-year period.
Main Results:
- Parathyroid autofluorescence successfully identified 179 out of 205 glands (87.3% accuracy).
- Adjacent tissues like thyroid, lymph nodes, muscle, and adipose tissue showed minimal to no autofluorescence.
- The technique demonstrated specificity for parathyroid tissue.
Conclusions:
- Parathyroid glands exhibit unique autofluorescence, enabling their identification during surgery.
- Intraoperative visualization of parathyroid autofluorescence can aid in preserving these glands and their vascular supply.
- This method holds promise for reducing the incidence of postoperative hypocalcemia.
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