Intraoperative identification of parathyroid glands during endocrine surgery

A. Bubnov, K. Slashchuk, E. Shirshin, V. Timoshenko
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Abstract

Nowadays, diabetes and diseases of thyroid gland take place on the first two stage in the rank of all endocrine diseases. There are 3 directions to treat thyroid glands pathologies such as: using special pills which substitute natural thyroid hormones, surgery and radioiodine therapy. It has proven that surgery of thyroid gland is the most effective method among considering upper. at The same time, it is associated with the greatest risks of complications. The most common injuries are damage to the recurrent laryngeal nerve and unintentional traumatization or removal of a healthy parathyroid gland. Parathyroid gland is a critical organ during thyroid surgery. It means that all negative reaction nearby the structure can lead to development different complications: hypoparathyroidism (transient or chronic) and hypocalcemia. In this article is considered actual methods of intraoperative optical visualization of parathyroid glans. The fundamental foundations of such methods, their advantages and disadvantages are also analyzed. It is shown that fluorescent methods in the red and near infrared regions of the spectrum using exogenous dyes have essential importance for endocrine surgery, as they allow to improve identification and reduce the risk of postoperative complications.
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内分泌外科手术中甲状旁腺的术中识别
目前,糖尿病和甲状腺疾病在所有内分泌疾病中排名前两位。治疗甲状腺疾病有三个方向,如:使用替代天然甲状腺激素的特殊药丸、手术和放射性碘治疗。甲状腺手术已被证明是考虑上甲状腺手术中最有效的方法。同时,它与并发症的最大风险相关。最常见的损伤是喉返神经损伤和健康甲状旁腺的意外创伤或切除。甲状旁腺是甲状腺手术中的重要器官。这意味着结构附近的所有阴性反应都会导致不同的并发症:甲状旁腺功能减退症(短暂性或慢性)和低钙血症。本文考虑了甲状旁腺术中光学显像的实际方法。分析了这些方法的基本原理、优缺点。研究表明,在光谱的红色和近红外区域使用外源染料的荧光方法对内分泌手术至关重要,因为它们可以改进识别并降低术后并发症的风险。
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审稿时长
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