Background:This study investigates the use of near-infrared fluorescence imaging (NIFI) as an alternative to intraoperative parathyroid hormone (ioPTH) measurement in patients with primary hyperparathyroidism (PHP) due to parathyroid adenoma (PA) with two preoperative imaging examinations in agreement on the position of the altered parathyroid gland.Methods:Fifty patients who underwent minimally invasive parathyroidectomy (MIP) from March 2021 to April 2024 were enrolled. MIPs utilised both NIFI and ioPTH, comparing the time to adenoma excision with NIFI against the total surgical time, including ioPTH measurement wait time.Results:Results showed successful MIPs in all patients, with a mean excision time of 44.7 min (SD ± 25.2) and a total procedure time of 85.5 min (SD ± 37.1). The median of the duration of the surgical procedure until adenoma excision was 35.0 min (IQR 38.8), while the median duration of the entire procedure was 74.5 min (IQR 40.5). This difference in medians is statistically significant using the Wilcoxon non-parametric test for paired samples (p< 0.001). The average wait for ioPTH results post-excision was 37 min (SD ± 12.2). Three fluorescence patterns were identified: “cap” (46%), heterogeneous (30%), and homogeneous (24%).Conclusions:If preoperative imaging confirms PA location, NIFI could replace ioPTH reducing surgical time without compromising success rates.
背景：本研究探讨在术前两项影像学检查对异常甲状旁腺位置判定一致的原发性甲状旁腺功能亢进症（PHP）患者中，应用近红外荧光成像（NIFI）替代术中甲状旁腺激素（ioPTH）监测的可行性。 方法：纳入2021年3月至2024年4月期间接受微创甲状旁腺切除术（MIP）的50例患者。所有手术同时采用NIFI与ioPTH监测，比较NIFI引导下的腺体切除时间与包含ioPTH结果等待时间在内的总手术时长。 结果：所有患者均成功完成MIP，平均腺体切除时间为44.7分钟（标准差±25.2），总手术时长为85.5分钟（标准差±37.1）。腺体切除阶段手术时长的中位数为35.0分钟（四分位距38.8），而总手术时长的中位数为74.5分钟（四分位距40.5）。配对样本Wilcoxon非参数检验显示中位数差异具有统计学意义（p<0.001）。切除术后等待ioPTH结果的平均时间为37分钟（标准差±12.2）。共识别出三种荧光模式：“帽状”荧光（46%）、不均匀荧光（30%）和均匀荧光（24%）。 结论：若术前影像学已明确甲状旁腺腺瘤位置，NIFI可替代ioPTH监测，在保证手术成功率的同时显著缩短手术时间。
肿瘤(癌症)患者之家