A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques

Identification of the parathyroid glands (PGs) during thyroid surgery may prevent their inadvertent surgical removal and prevent postoperative hypoparathyroidism. However, identification of the PGs does not guarantee their function, and their vascular supply needs to be preserved as well. The recent...

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Published inGland surgery Vol. 6; no. Suppl 1; pp. S30 - S37
Main Authors Sadowski, Samira Mercedes, Vidal Fortuny, Jordi, Triponez, Frederic
Format Journal Article
LanguageEnglish
Published China (Republic : 1949- ) AME Publishing Company 01.12.2017
Subjects
Review
indocyanine green fluorescence (ICG fluorescence)
postoperative hypoparathyroidism
Parathyroid gland (PG)
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Summary:Identification of the parathyroid glands (PGs) during thyroid surgery may prevent their inadvertent surgical removal and prevent postoperative hypoparathyroidism. However, identification of the PGs does not guarantee their function, and their vascular supply needs to be preserved as well. The recent introduction of intraoperative indocyanine green (ICG) fluorescent angiography of the PGs during thyroid surgery allows for the appraisal of the vascular anatomy and evaluation of PG function. The use of this tool could lead to a significant reduction in the rate of postoperative hypoparathyroidism, as it allows surgeons to adapt their surgical technique for the preservation of the PGs. ICG fluorescent angiography is currently the only available real-time tool to assess the vascular blood supply of each individual PG intraoperatively and can thus assist surgeons in their decision-making. Herein, we review the relevant literature.
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Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: SM Sadowski, J Vidal Fortuny; (V) Data analysis and interpretation: SM Sadowski, F Triponez; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
ISSN:2227-684X
2227-8575
DOI:10.21037/gs.2017.07.10