The application of autofluorescence system contributes to the preservation of parathyroid function during thyroid surgery

• Published in: Langenbeck's archives of surgery Vol. 409; no. 1; p. 96
• Main Authors: Shi, XianBiao, Lv, Guan, Qin, JiaBo, Li, Yixuan, Zheng, Lulu, Ding, Haoran, Sang, JianFeng
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 14.03.2024
• Subjects: Abdominal Surgery; Calcium; Cardiac Surgery; General Surgery; Humans; Hypocalcemia - etiology; Hypocalcemia - prevention & control; Hypoparathyroidism - etiology; Hypoparathyroidism - prevention & control; Medicine; Medicine & Public Health; Parathyroid Glands - surgery; Parathyroid Hormone; Postoperative Complications - etiology; Thoracic Surgery; Thyroid Neoplasms - surgery; Thyroidectomy - adverse effects; Traumatic Surgery; Vascular Surgery; Thyreoidectomy; Central lymph node dissection; Hypoparathyroidism; Autofluorescence
• ISSN: 1435-2451; 1435-2451
• DOI: 10.1007/s00423-024-03256-5

Purpose The purpose of this study was to investigate the impact of autofluorescence technology on postoperative parathyroid function and short-term outcomes in patients undergoing thyroid surgery. Methods A total of 546 patients were included in the study, with 287 in the conventional treatment group and 259 in the autofluorescence group. Both groups underwent central lymph node dissection, which is known to affect parathyroid function. Short-term outcomes, including rates of postoperative hypocalcemia and parathyroid dysfunction, serum calcium and PTH levels on the first postoperative day, as well as the need for calcium supplementation, were analyzed. A multivariable analysis was also conducted to assess the impact of autofluorescence on postoperative parathyroid dysfunction, considering factors such as age, BMI, and preoperative calcium levels. Results The autofluorescence group demonstrated significantly lower rates of postoperative hypocalcemia and parathyroid dysfunction compared to the conventional treatment group. The autofluorescence group also had better serum calcium and PTH levels on the first postoperative day, and a reduced need for calcium supplementation. Surprisingly, the use of autofluorescence technology did not prolong surgical time; instead, it led to a shorter hospitalization duration. The multivariable analysis showed that autofluorescence significantly reduced the risk of postoperative parathyroid dysfunction, while factors such as age, BMI, and preoperative calcium levels did not show a significant correlation. Conclusion This study provides evidence that autofluorescence technology can improve the preservation of parathyroid function during thyroid surgery, leading to better short-term outcomes and reduced postoperative complications. The findings highlight the potential of autofluorescence as a valuable tool in the management of parathyroid hypofunction. Further research and validation are needed to establish the routine use of autofluorescence technology in the thyroid.