Application prospect of intraoperative optical localization and activity determination of parathyroid gland in thyroid and parathyroid surgery
10.3760/cma.j.cn.115807-20200426-00136
- VernacularTitle:术中甲状旁腺光学定位与活性判断在甲状腺和甲状旁腺外科的应用前景
- Author:
Yingchao ZHANG
1
;
Bo WU
;
Youben FAN
Author Information
1. 上海交通大学附属第六人民医院普外科，上海交通大学甲状腺疾病诊治中心 200233
- From:
Chinese Journal of Endocrine Surgery
2020;14(5):432-435
- CountryChina
- Language:Chinese
-
Abstract:
One of the major risks of total thyroidectomy, especially with central cervical lymph node dissection, is unintentional resection and devascularization of the parathyroid gland (PG) , which leads to temporary or permanent hypoparathyroidism (hypoPT) and causes hypocalcemia. Nowadays postoperative hypoPT is one of the most troubling complications for both surgeons and patients all around the world. In addition, primary or renal hypoPT requires the removal of pathological PG (s) . However, rapid identification of PGs, particularly ectopic or excess PG, could be sometimes difficult. Currently, the identification and protection of PGs mainly depend on the experience of surgeons and auxiliary methods such as fast frozen pathology, the negative imaging through nano-carbon, or PTH test strip, still have some limitations. As initial researches show, near-infrared autofluorescence imaging and optical coherence tomography can accurately perform the real-time identification of PGs; indocyanine green fluorescence or laser speckle contrast imaging can help to judge the activity of PGs intraoperatively. The basic principle, clinical application and prospect of these optical techniques in thyroid and parathyroid surgery will be reviewed in our article.
