Indocyanine green fluorescence-guided parathyroidectomy for primary hyperparathyroidism.
Surgery
; 163(2): 388-392, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-29129358
ABSTRACT
BACKGROUND:
Our aim was to evaluate the ease and utility of using indocyanine green fluorescence angiography for intraoperative localization of the parathyroid glands.METHODS:
Indocyanine green fluorescence angiography was performed during 60 parathyroidectomies for primary hyperparathyroidism during a 22-month period. Indocyanine green was administered intravenously to guide operative navigation using a commercially available fluorescence imaging system. Video files were graded by 3 independent surgeons for strength of enhancement using an adapted numeric scoring system.RESULTS:
There were 46 (77%) female patients and 14 (23%) male patients whose ages ranged from 17 to 87 (average 60) years old. Of the 60 patients, 43 (71.6%) showed strong enhancement, 13 (21.7%) demonstrated mild to moderate vascular enhancement, and 4 (6.7%) exhibited little or no vascular enhancement. Of the 54 patients who had a preoperative sestamibi scan, a parathyroid adenoma was identified in 36, while 18 failed to localize. Of the 18 patients who failed to localize, all 18 patients (100%) had an adenoma that fluoresced on indocyanine green imaging. The operations were performed safely with minimal blood loss and short operative times.CONCLUSION:
Indocyanine green angiography has the potential to assist surgeons in identifying parathyroid glands rapidly with minimal risk.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias das Paratireoides
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Adenoma
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Paratireoidectomia
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Hiperparatireoidismo Primário
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Verde de Indocianina
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article