PDF(Pubmed)
Abstract：
BACKGROUND: Risk of postoperative transient or permanent hypoparathyroidism represents one of the most common complications following total thyroidectomy. This risk increases if a cervical lymphadenectomy procedure must also be performed, as is usually the case in thyroid carcinoma patients. Parathyroid autofluorescence (AF) is a non-invasive method that aids intraoperative identification of parathyroid glands.
METHODS: In this prospective study, 189 patients with papillary thyroid cancer who underwent total thyroidectomy with central neck dissection were included. Patients were randomly allocated to one of two groups: NAF (no AF, surgery was performed without AF) and the AF group (surgery was performed with AF-Fluobeam LX system, Fluoptics, Grenoble, France).
RESULTS: The number of excised lymph nodes was significantly higher in the AF compared to the NAF group, with mean values of 21.3 ± 4.8 and 9.2 ± 4.1, respectively. Furthermore, a significantly higher number of metastatic lymph nodes were observed in the AF group. Transient hypocalcemia recorded significantly lower rates in the AF group with 4.9% compared to 16.8% in the NAF group.
CONCLUSIONS: AF use during total thyroidectomy with central neck dissection for papillary thyroid carcinoma patients, decreased the rate of iatrogenic parathyroid gland lesions, and increased the rate of lymphatic clearance.
METHODS: In this prospective study, 189 patients with papillary thyroid cancer who underwent total thyroidectomy with central neck dissection were included. Patients were randomly allocated to one of two groups: NAF (no AF, surgery was performed without AF) and the AF group (surgery was performed with AF-Fluobeam LX system, Fluoptics, Grenoble, France).
RESULTS: The number of excised lymph nodes was significantly higher in the AF compared to the NAF group, with mean values of 21.3 ± 4.8 and 9.2 ± 4.1, respectively. Furthermore, a significantly higher number of metastatic lymph nodes were observed in the AF group. Transient hypocalcemia recorded significantly lower rates in the AF group with 4.9% compared to 16.8% in the NAF group.
CONCLUSIONS: AF use during total thyroidectomy with central neck dissection for papillary thyroid carcinoma patients, decreased the rate of iatrogenic parathyroid gland lesions, and increased the rate of lymphatic clearance.
摘要：
背景：术后暂时性或永久性甲状旁腺功能减退症的风险是甲状腺全切除术后最常见的并发症之一。如果必须进行颈淋巴结清扫术，这种风险会增加，甲状腺癌患者通常如此。甲状旁腺自发荧光（AF）是一种非侵入性方法，有助于术中识别甲状旁腺。
方法：在这项前瞻性研究中，189例甲状腺乳头状癌患者行甲状腺全切除术伴中央颈清扫术。患者随机分为两组：NAF（无AF，手术是在无AF的情况下进行的)和AF组(手术是用AF-荧光LX系统进行的,Fluopics,格勒诺布尔,法国)。
结果：与NAF组相比，AF组中切除的淋巴结数量明显更高，平均值分别为21.3±4.8和9.2±4.1。此外，在AF组中观察到明显更多的转移性淋巴结.与NAF组的16.8%相比，房颤组的短暂性低钙血症发生率明显降低，为4.9%。
结论：甲状腺乳头状癌患者在甲状腺全切除术和中央颈清扫术中使用AF，降低医源性甲状旁腺病变的发生率，并提高了淋巴清除率。
方法：在这项前瞻性研究中，189例甲状腺乳头状癌患者行甲状腺全切除术伴中央颈清扫术。患者随机分为两组：NAF（无AF，手术是在无AF的情况下进行的)和AF组(手术是用AF-荧光LX系统进行的,Fluopics,格勒诺布尔,法国)。
结果：与NAF组相比，AF组中切除的淋巴结数量明显更高，平均值分别为21.3±4.8和9.2±4.1。此外，在AF组中观察到明显更多的转移性淋巴结.与NAF组的16.8%相比，房颤组的短暂性低钙血症发生率明显降低，为4.9%。
结论：甲状腺乳头状癌患者在甲状腺全切除术和中央颈清扫术中使用AF，降低医源性甲状旁腺病变的发生率，并提高了淋巴清除率。
