Identification of Pathological and Normal Parathyroid Tissue by Fluorescent Labeling with 5-aminolevulinic Acid during Endocrine Neck Surgery

Takeuchi, Shinichi; Shimizu, Kazuo; Shimizu, Kiyotaka; Akasu, Haruki; Okamura, Ritsuko

doi:10.1272/jnms.81.84

Cited by 22 publications

(16 citation statements)

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“…A technique in which both abnormal and normal PGs can be identified is fluorescence imaging with 5-aminolevulinic acid. 12 However, this technique also has its side effects and requires extensive photosensitization preparation and thereby, patients have to be shielded from direct light exposure for 48 hours to prevent phototoxic reactions. 13 A promising technique to visualize healthy and diseased parathyroid tissue has emerged in the use of intraoperative NIRF imaging using intravenously administered indocyanine green (ICG).…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery

et al. 2018

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Background This study assessed the feasibility of near‐infrared fluorescence imaging with indocyanine green (ICG) to identify the parathyroid glands (PGs) intraoperatively and to assess their perfusion after thyroid resection. Methods Patients undergoing elective thyroidectomy were enrolled in this prospective study. An intravenous bolus of 7.5 mg ICG was administered twice: the first bolus to identify the PGs before resection of the thyroid and the second to assess vascularization of the PGs after resection. Results A total of 30 operations in 26 patients were included. In 17 surgeries (56.7%), fluorescence imaging was of added value, especially to confirm the presence of a suspected PG. No intraoperative or postoperative complications occurred because of the use of ICG. Conclusion Near‐infrared fluorescence imaging with the use of ICG for intraoperative identification of the PGs and the assessment of its vascularization is feasible and safe and can provide more certainty about the location of the PGs.

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Section: Introductionmentioning

confidence: 99%

“…A technique in which both abnormal and normal PGs can be identified is fluorescence imaging with 5‐aminolevulinic acid . However, this technique also has its side effects and requires extensive photosensitization preparation and thereby, patients have to be shielded from direct light exposure for 48 hours to prevent phototoxic reactions …”

Section: Introductionmentioning

confidence: 99%

Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery

et al. 2018

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“…High 5-ALA uptake in the parathyroid gland is explained by the high number of mitochondria in the parathyroid cells. [70,71] Prost et al [70] reported that a total of 92% of the glands in pHPT and secondary HPT can be detected, and that in 48% of the patients, this method accelerated the localization of the pathological glands. It has been claimed to be a simple method in the differentiation between the normal and pathological parathyroid glands.…”

Section: Combination Of Autofluorescence With Methylene Blue Stainingmentioning

confidence: 99%

“…It has been claimed to be a simple method in the differentiation between the normal and pathological parathyroid glands. [71] After 5-ALA is applied to prevent the phototoxic effects of the eye and skin, the patient's avoidance of direct light for 24-48 h is its main disadvantage. [70] Angiography with Intraoperative ICG…”

Section: Combination Of Autofluorescence With Methylene Blue Stainingmentioning

confidence: 99%

Primer Hiperparatiroidizmde Cerrahi Tedavi: Kime Hangi Tedavi?

Aygün

Uludağ

2019

Sisli Etfal

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Intraoperative Adjunct Methods for Localization in Primary Hyperparathyroidism T he curative treatment of primary hyperparathyroidism (pHPT) is surgery. The causative agent of the disease in pHPT is parathyroid adenomas originating from a single gland in 80-85% of the cases. After the third quarter of the last century, preoperative imaging methods have been rapidly developed, most of the pathological glands could be determined. In addition, intraoperative gamma probe application, ultrasonography (USG), methylene blue, and/ or frozen section examination are being used to increase the success in parathyroidectomy. Recently, promising studies regarding different parathyroid imaging modalities with optical technologies to identify the intraoperative parathyroid glands have been noteworthy. Currently, bilateral neck exploration (BNE) is the gold standard in the surgical treatment of pHPT. [1] However, with the contribution of imaging modalities and especially intraoperative parathyroid hormone (PTH) mea-Primary hyperparathyroidism (pHPT) is a frequently seen endocrine disease, and its main treatment is surgery. In the majority of pHPT, the disease involves only a single gland, and the majority of the pathological glands can be determined by preoperative localization methods.In addition to preoperative localization studies in parathyroidectomy, the use of adjunct methods to improve intraoperative localization in order to increase success of surgery is becoming widespread. These methods include different approaches, mainly intraoperative parathyroid hormone (PTH) measurement, followed by intraoperative gamma probe application, intraoperative ultrasonography, parathyroid imaging with methylene blue, and frozen section examination. Recently, especially promising new imaging methods have been described in the literature with various optical technologies to increase the localization of the parathyroid glands and to evaluate their viability. These methods include parathyroid imaging with autofluorescence, indocyanine green imaging with autofluorescence, autofluorescence imaging with methylene blue, autofluorescence imaging with 5-aminolevulinic acid, optical coherence tomography, laser speckle contrast imaging, dynamic optical contrast imaging, and Raman spectroscopy. Currently, minimally invasive parathyroidectomy has become the standard treatment for selected pHPT patients with the aid of preoperative imaging and intraoperative auxiliary methods. The aim of the present study was to evaluate the routinely used new promising intraoperative adjunct methods in pHPT.

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“…Для профилактики данного осложнения некоторые авторы при пересечении даже мелких сосудов рекомендуют применение миниатюрных (3 мм) титановых скоб [20]. Частота развития послеоперационной гипокальциемии побуждает к использованию методики интраоперационной фотодинамической визуализации паращитовидных желез с использованием флюоресцентных веществ, предлагаемой некоторыми авторами [4,22].…”

Section: информативность инструментальных методов диагностики в выявлunclassified

Substantiation of minimally invasive surgeries on thyroid gland

Майстренко

Romashchenko

Криволапов

2017

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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Кафедра и клиника факультетской хирургии им. С. П. Фёдорова (зав. -акад. РАН проф. Н. А. Майстренко), ФГБВОУ ВО «Военно-медицинская академия им. С. М. Кирова» МО РФ, Санкт-Петербург ЦЕЛЬ ИССЛЕДОВАНИЯ. Определить критерии отбора больных хирургическими заболеваниями щитовидной железы (ЩЖ) для обоснованного выполнения оптимальных минимально-инвазивных оперативных вмешательств. МАТЕРИАЛ И МЕТОДЫ. Проанализированы результаты лечения 322 пациентов с хирургическими заболеваниями ЩЖ, которые были прооперированы с применением традиционного и различных малоинвазивных доступов. РЕЗУЛЬТАТЫ. Установлено, что основными критериями, обусловливающими выбор рационального минимально-инвазивного вмешательства, являются: размер узловых образований и объём ЩЖ; аутоиммунное воспаление тиреоидной ткани на фоне узлового токсического и диффузного токсического зоба; загрудинное расположение зоба; необходимость выполнения центральной лимфодиссекции при метастатическом поражении лимфатических узлов. ЗАКЛЮЧЕНИЕ. Применение установленных критериев на основе комплексного использования современных диагностических методик у больных с хирургическими заболеваниями ЩЖ позволяет обосновать выбор оптимальных минимально-инвазивных оперативных вмешательств, избежать неоправданных операций и улучшить результаты лечения. Substantiation of minimally invasive surgeries on thyroid glandDepartment and clinic of faculty surgery named after S. P. Fyodorov, S. M. Kirov Military Medical Academy, St. Petersburg OBJECTIVE. The authors determined criteria for reasonable selection of patients for application of optimal minimally invasive interventions in cases of thyroid gland diseases. MATERIAL AND METHODS. The treatment results of 322 patients with thyroid gland diseases were analyzed. There were used a conventional method and variety of minimally invasive methods. RESULTS. It was stated that the main criteria that verified a choice of optimal minimally invasive surgery were the nodule size and thyroid gland volume, autoimmune inflammation of thyroid tissues against a background of toxic and diffuse toxic goiter, retrosternal goiter position and necessity of central lymphodissection in case of metastatic thyroid gland. CONCLUSIONS. The authors applied the determined criteria based on modern diagnostic methods in patients with surgical thyroid gland diseases. This study allowed doctors to justify the choice of optimal minimally invasive surgeries and avoid unreasonable operations, improve treatment results.

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Identification of Pathological and Normal Parathyroid Tissue by Fluorescent Labeling with 5-aminolevulinic Acid during Endocrine Neck Surgery

Cited by 22 publications

References 23 publications

Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery

Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery

Primer Hiperparatiroidizmde Cerrahi Tedavi: Kime Hangi Tedavi?

Substantiation of minimally invasive surgeries on thyroid gland

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