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.
背景：术后暂时性或永久性甲状旁腺功能减退是甲状腺全切除术后最常见的并发症之一。若同时需行颈部淋巴结清扫术（甲状腺癌患者通常如此），该风险将进一步增加。甲状旁腺自体荧光技术是一种有助于术中识别甲状旁腺的无创方法。方法：本前瞻性研究纳入189例接受甲状腺全切除联合中央区淋巴结清扫术的甲状腺乳头状癌患者。患者被随机分为两组：NAF组（未使用自体荧光技术）和AF组（使用法国格勒诺布尔Fluoptics公司的Fluobeam LX系统进行自体荧光引导手术）。结果：AF组切除淋巴结数量显著高于NAF组，均值分别为21.3±4.8枚和9.2±4.1枚。此外，AF组转移性淋巴结数量也显著更高。AF组暂时性低钙血症发生率（4.9%）显著低于NAF组（16.8%）。结论：在甲状腺乳头状癌患者行甲状腺全切除联合中央区淋巴结清扫术时应用自体荧光技术，可降低医源性甲状旁腺损伤发生率，并提高淋巴结清扫率。
Improvement in Central Neck Dissection Quality in Thyroid Cancer by Use of Tissue Autofluorescence
肿瘤(癌症)患者之家