Indocyanine green fluorescence angiography-guided transoral endoscopic thyroidectomy and parathyroidectomy: First clinical report
| Autor: | Mehmet Erturk, Mehmet Celik, Mehmet Ilker Turan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Indocyanine Green
Parathyroidectomy medicine.medical_specialty medicine.medical_treatment 030303 biophysics Biophysics Parathyroid hormone Dermatology Fluorescence 030207 dermatology & venereal diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Humans Pharmacology (medical) Fluorescein Angiography 0303 health sciences Photosensitizing Agents medicine.diagnostic_test business.industry Thyroid Cosmesis medicine.disease Mental nerve Surgery medicine.anatomical_structure Photochemotherapy Oncology chemistry Seroma Angiography Thyroidectomy business Indocyanine green |
| Zdroj: | Photodiagnosis and Photodynamic Therapy. 32:102028 |
| ISSN: | 1572-1000 |
| DOI: | 10.1016/j.pdpdt.2020.102028 |
| Popis: | Background Indocyanine green fluorescence (ICG) angiography has been used for many purposes including as part of a focused parathyroidectomy technique. Concomitant fluorescence of thyroid tissue may cause challenges defining parathyroid tissue during surgery, since ICG is not a selective fluorescent agent. On the other hand, cosmesis is still a big problem for patients due to the visible neck scars produced by the standard surgical technique. In this study, we described a novel technique to solve both these handicaps. Materials and methods Seven patients who underwent ICG fluorescence angiography-guided transoral endoscopic thyroidectomy and parathyroidectomy vestibular approach between February 2018 and July 2019 were included. Serum parathyroid hormone (PTH) levels were measured intraoperatively and on postoperative day 1. Fluorescent images were confirmed with intraoperative quick-PTH levels. Results All operations were done successfully without conversion to open surgery. Intense and isolated parathyroid fluorescent images were achieved in all operations. All patients had a 50 % decrease between the baseline and final quick-PTH levels and the final quick-PTH levels were in the normal range in all. One of 7 patients had epistaxis due to nasotracheal intubation. One of 7 patients had seroma on post-operative day 5. None of patients had mental nerve injury, permanent hypocalcemia and temporary or permanent recurrent laryngeal nerve injury. Conclusion ICG-guided transoral endoscopic thyroid and parathyroid surgery can be used in select patients to increase operative success in focused parathyroidectomy with excellent cosmetic outcome also noted. |
| Databáze: | OpenAIRE |
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