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Fluorescence Image-Guided Surgery for Thyroid Cancer: Utility for Preventing Hypoparathyroidism
Marco Stefano Demarchi1,2, Barbara Seeliger3,4,5,6, Jean-Christophe Lifante2,7
1Department of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211 Geneva, Switzerland.
Cancers
|August 7, 2021
Summary
Fluorescence-guided surgery aids in preserving parathyroid glands during thyroid cancer operations. This technique enhances visualization, reducing the risk of hypoparathyroidism after thyroidectomy, especially with lymph node dissection.
Area of Science:
- Surgical Oncology
- Endocrinology
- Medical Imaging
Background:
- Hypoparathyroidism is a common complication following thyroid surgery, particularly in thyroid cancer cases involving lymph node dissection.
- Emerging fluorescence-guided surgery techniques show promise in mitigating this complication.
Purpose of the Study:
- To review the effectiveness of fluorescence imaging in parathyroid gland preservation during thyroid cancer surgery.
Main Methods:
- A systematic literature review adhering to PRISMA guidelines was conducted.
- Studies were selected based on indication, surgical type, fluorescence method (autofluorescence or exogenous dye), and outcomes.
- Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS).
Main Results:
- Twenty-five studies met the inclusion criteria; three focused exclusively on thyroid cancer.
- The majority of studies indicate that fluorescence imaging offers benefits for parathyroid gland preservation in thyroid surgery.
- Enhanced visualization aids in identifying and preserving parathyroid glands.
Conclusions:
- Fluorescence-guided surgery is a valuable tool for preventing post-thyroidectomy hypoparathyroidism.
- Improved identification and preservation of parathyroid glands are crucial, especially in complex thyroid cancer surgeries with lymphadenectomy.
