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Background <p>Recently, several devices exploiting the near-infrared autofluorescence (NIR-AF) of parathyroid glands (PGs) have been developed. Nevertheless, their impact on both preserving PGs from inadvertent surgical dissection and on post-surgical hypoparathyroidism (hypoPTH) is controversial.</p> Methods <p>A retrospective study of 845 patients undergoing thyroid surgery in 2 academic tertiary centres was conducted. In 291 patients, a NIR-AF device was used during surgery to identify PGs. The characteristics of the cohort were examined. The number of PGs identified during surgery, missed PGs, auto-transplants, inadvertent parathyroidectomies, as well as the occurrence of transient and permanent hypoPTH, were analysed.</p> Results <p>The use of NIR-AF device resulted in a higher identification of PGs (92% versus 88%, <i>p</i> = 0.0008), and a significant reduction in the number of PGs inadvertently removed and detected on histopathological examination (4.7% versus 6.5%, <i>p</i> = 0.045). An increase in PG auto-transplantations was observed in the NIR-AF + group (10.4% versus 3.5%, <i>p</i> &lt; 0.0001). The use of NIRAF did not significantly impact the occurrence of either transient or permanent hypoPTH.</p> Conclusion <p>Intraoperative NIR-AF detection is a promising technology to reduce incidental parathyroidectomies in thyroid surgery. The impact of this technology on the occurrence of post-surgical hypoPTH needs to be furtherly investigated.</p>

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Will the autofluorescence take over inadvertent parathyroidectomy? Results from a multicentre cohort study

  • 期刊论文

  • 发表日期：

    2025年1月17日

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  • Diego Barbieri,
  • Pietro Indelicato,
  • Simone De Leo,
  • Claudia Moneta,
  • Silvia Coccia,
  • Giacomo Gazzano,
  • Leone Giordano,
  • Francesca Lira Luce,
  • Davide Canta,
  • Laura Fugazzola,
  • Mario Bussi,
  • Gianlorenzo Dionigi,
  • Matteo Trevisan

摘要

Background

Recently, several devices exploiting the near-infrared autofluorescence (NIR-AF) of parathyroid glands (PGs) have been developed. Nevertheless, their impact on both preserving PGs from inadvertent surgical dissection and on post-surgical hypoparathyroidism (hypoPTH) is controversial.

Methods

A retrospective study of 845 patients undergoing thyroid surgery in 2 academic tertiary centres was conducted. In 291 patients, a NIR-AF device was used during surgery to identify PGs. The characteristics of the cohort were examined. The number of PGs identified during surgery, missed PGs, auto-transplants, inadvertent parathyroidectomies, as well as the occurrence of transient and permanent hypoPTH, were analysed.

Results

The use of NIR-AF device resulted in a higher identification of PGs (92% versus 88%, p = 0.0008), and a significant reduction in the number of PGs inadvertently removed and detected on histopathological examination (4.7% versus 6.5%, p = 0.045). An increase in PG auto-transplantations was observed in the NIR-AF + group (10.4% versus 3.5%, p < 0.0001). The use of NIRAF did not significantly impact the occurrence of either transient or permanent hypoPTH.

Conclusion

Intraoperative NIR-AF detection is a promising technology to reduce incidental parathyroidectomies in thyroid surgery. The impact of this technology on the occurrence of post-surgical hypoPTH needs to be furtherly investigated.