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New imaging device reduces hypocalcemia after thyroidectomy

November 13, 2019 13:44

Autofluorescence imaging using near infrared light to detect the parathyroid glands during thyroid surgery reduces the incidence of postoperative hypocalcemia, since it allows to visualize the prostate long before they see the surgeon.

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 "Autofluorescence imaging allows imaging of the parathyroid glands at a very early stage, which will keep the parathyroid glands during surgery on the thyroid gland", - said the first doctor Benmilud Perez, MD, general surgery in the European hospital in Marseille.

Results of the study were presented at the 89th annual meeting of the thyroid gland of the American Association. The device used in the study was approved a year ago by the Office of the US Food and Drug Administration to determine the location of parathyroid tissue during surgical procedures. The results show significant benefits of using autofluorescence with a total thyroidectomy.

This is a promising method to help prevent inadvertent parathyroidectomy and the further prevention of hypocalcemia. Identification of the parathyroid glands during total thyroidectomy can be daunting, and if cancer inadvertently damaged, patients may develop postoperative hypocalcemia, a potentially serious complication.

Previous studies have shown that when exposed to light, near infrared, parathyroid glands emit natural autofluorescence signal, from which you can receive images, allowing you to identify the parathyroid glands.

To assess the potential benefits of imaging method for the prevention, the researchers selected 241 patients in three hospitals in France, which total thyroidectomy was performed. The average age of patients was 53.6 years, and women accounted for 79.3% of the participants. Under autofluorescence imaging significantly fewer patients had parathyroid autotransplantation. The authors note that 61.6% of the parathyroid glands were identified by this method.

Temporary hypocalcemia is highly undesirable result. "Temporary hypocalcemia may even become life-threatening if not treated - the researchers say -. It is necessary to control and tend to be treated by oral calcium calcitriol for a certain period of time This may lead to complications associated with the treatment, such. as necrosis of the skin in case extravasation calcium gluconate, constipation or hypercalcemia. "

However, clinicians should learn to read autofluorescence images. There is a learning curve that allows to correctly interpret the results of the image to distinguish the fluorescent images corresponding to parathyroid, and false-positive images. It should be noted that the average duration of the operation in the study was 99 minutes in the group autofluorescence imaging and 91 minutes in the traditional approach.

In the future, the new method will show whether the results generalize, and whether there can be achieved reduction of postoperative hypocalcemia. Researchers say the need for additional research to improve the method.

Source: https://www.medscape.com/viewarticle/921106#vp_2

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