The impact of near-infrared autofluorescence on postoperative hypoparathyroidism during total thyroidectomy: a case-control study.

Autor: Barbieri D; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. barbieri.diego@hsr.it., Indelicato P; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy., Vinciguerra A; Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France., Salerno E; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy., Battista RA; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy., Di Marco F; Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy., Giordano L; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy., Luce FL; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy., Bondi S; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS Candiolo Cancer Institute, Torino, Italy., Trimarchi M; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy., Bussi M; Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Jazyk: angličtina
Zdroj: Endocrine [Endocrine] 2023 Feb; Vol. 79 (2), pp. 392-399. Date of Electronic Publication: 2022 Oct 17.
DOI: 10.1007/s12020-022-03222-5
Abstrakt: Purpose: Near-infrared autofluorescence is a new technology in thyroid surgery to better localize and preserve parathyroid glands. The purpose of this study is to assess if the adoption of NIR-AF can improve in short-, medium-, and long-term post-operative calcium and PTH levels compared to conventional "naked eye" surgery in patients undergoing TT for benign or malignant conditions.
Methods: 134 patients undergone total thyroidectomy between January 2020 and June 2022; 67 were treated with conventional thyroidectomy, the other 67 underwent surgery adopting an autofluorescence detecting device.
Results: Significant differences were found between the two groups in percentage of patients with short-term hypocalcemia (p = 0.04) and short-term hypoparathyroidism (p = 0.011). Median short-term (p = 0.01) and medium-term (p = 0.03) PTH levels were significantly higher in autofluorescence group, while, short- (p = 0.001), medium- (p < 0.001) and long-term (p = 0.019) percentage variation of PTH levels from baseline were significantly higher in the standard-care group. Finally, the prescription of oral calcium (p < 0.01) after surgery were significantly lower in the autofluorescence group.
Conclusion: The adoption of near-infrared autofluorescence during total thyroidectomy is related to lower short-term hypocalcemia and hypoparathyroidism rates, decreased variation of post-operative PTH levels in short- and medium- and long-term, reducing the necessity of supplementation therapy with oral calcium compared to conventional surgery.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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