Current state of intraoperative use of near infrared fluorescence for parathyroid identification and preservation.

Current state of intraoperative use of near infrared fluorescence for parathyroid identification and preservation.
复制标题

术中近红外荧光用于甲状旁腺识别和保存的现状。

DOI:
10.1016/j.surg.2020.09.014
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发表时间:
2021-04
期刊:
影响因子:
3.8
通讯作者:
Triponez F
Triponez F
中科院分区:
医学2区
文献类型:
--
作者:
Solórzano CC;Thomas G;Berber E;Wang TS;Randolph GW;Duh QY;Triponez F

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寻找并保存正常的甲状旁腺或定位并切除患病的甲状旁腺是成功进行甲状腺和甲状旁腺手术的关键步骤。在甲状腺和甲状旁腺手术期间使用近红外荧光检测来识别甲状旁腺最近获得了广泛的认可,目前市场上有 2 种获得美国食品和药物管理局批准的设备。我们的目标是向内分泌外科界通报近红外荧光检测如何最有效地用于术中快速识别或保存甲状旁腺。使用相关搜索引擎中的关键术语“甲状旁腺”、“近红外”和“荧光”进行文献综述。根据文献综述和专家外科医生的意见,提出了在宫颈内分泌手术中应用近红外荧光检测来识别或保存甲状旁腺的建议。近红外荧光检测的范围可大致分为(1)使用近红外自发荧光来识别或定位健康和患病的甲状旁腺,以及(2)使用对比增强近红外荧光来评估甲状旁腺灌注。本文描述了两种基于近红外的方法的优点和缺点。近红外荧光检测似乎有助于甲状旁腺的识别和可能的保存。我们希望这些建议对执业内分泌外科医生在考虑将这些术中辅助剂纳入其手术实践中时有价值。
Finding and preserving normal parathyroid glands or localizing and removing diseased parathyroid glands are crucial steps to successful thyroid and parathyroid operations. Using near-infrared fluorescence detection to identify parathyroid glands during thyroid and parathyroid operations has lately gained widespread recognition, with 2 Food and Drug Administration-cleared devices currently in the market. We aim to update the endocrine surgery community on how near-infrared fluorescence detection can be most optimally used for rapid intraoperative parathyroid gland identification or preservation. A literature review was performed using the key terms: “parathyroid,” “near infrared,” and “fluorescence” in relevant search engines. Based on the reviewed literature and expert surgeons’ opinions, recommendations were formulated for applying near-infrared fluorescence detection to identify or preserve parathyroid glands during cervical endocrine surgery. The scope of near-infrared fluorescence detection can be broadly categorized into (1) using near-infrared auto-fluorescence to identify or locate both healthy and diseased parathyroid glands, and (2) using contrast-enhanced near-infrared fluorescence to evaluate parathyroid gland perfusion. The benefits and pitfalls for both near-infrared-based approaches are described herein. Near-infrared fluorescence detection appears helpful for identification and likely preservation of parathyroid glands. We hope these recommendations will be valuable to the practicing endocrine surgeon as they consider incorporating these intraoperative adjuncts in their surgical practice.
DOI: 10.3390/jcm9030830
发表时间: 2020-03-01
影响因子: 3.9
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