利用亚甲蓝注入法在术中快速定位甲状旁腺

Rapid intraoperative localization of parathyroid glands utilizing methylene blue infusion.

作者信息

Kuriloff Daniel B, Sanborn Kevin V

机构信息

Department of Otolaryngology-Head and Neck Surgery, St. Luke's-Roosevelt Hospital Center and Columbia Univeristy College of Physicians and Surgeons, New York, NY 10019-1104, USA.

出版信息

Otolaryngol Head Neck Surg. 2004 Nov;131(5):616-22. doi: 10.1016/j.otohns.2004.04.026.

DOI:10.1016/j.otohns.2004.04.026

PMID:15523436

Abstract

OBJECTIVE

To review a single surgeon's experience utilizing an intraoperative methylene blue infusion (IMBI) to identify parathyroid glands during neck exploration for primary hyperparathyroidism.

STUDY DESIGN AND SETTING

Retrospective review of 35 patients who underwent bilateral neck exploration utilizing an IMBI at a dose of 7.5 mg/kg following the induction of general anesthesia.

RESULTS

All patients reverted to normocalcemia with a mean follow-up of 17 months. IMBI facilitated the identification of abnormal parathyroid tissue in 34/35 patients (97%). A dark blue-purple staining was observed in 33/37 stained adenomas (89%). Four adenomas and four hyperplastic glands stained a lighter shade of blue-green. Among 89 normal glands, 41(46%) stained a pale green-grey color.

CONCLUSIONS

IMBI is a safe, readily available, cost-effective, and underutilized technique that facilitates rapid identification of parathyroid adenomas, helps distinguish normal glands from hyperplastic glands, and helps to locate ectopic glands. An overall reduction in operative time, especially for bilateral neck exploration, can be anticipated.

摘要