Nanjing Drum Tower Hospital, Nanjing, China.
Nanjing Medical University, Nanjing, China.
Langenbecks Arch Surg. 2024 Mar 14;409(1):96. doi: 10.1007/s00423-024-03256-5.
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.
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.
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.
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.
本研究旨在探讨荧光技术对甲状腺手术患者甲状旁腺功能及短期结局的影响。
共纳入 546 例患者，其中常规治疗组 287 例，荧光组 259 例。两组均行中央淋巴结清扫术，已知该术式会影响甲状旁腺功能。分析短期结局，包括术后低钙血症和甲状旁腺功能障碍的发生率、术后第 1 天血清钙和 PTH 水平以及钙补充的需要。还进行了多变量分析，以评估荧光对术后甲状旁腺功能障碍的影响，同时考虑年龄、BMI 和术前钙水平等因素。
与常规治疗组相比，荧光组术后低钙血症和甲状旁腺功能障碍的发生率显著降低。荧光组术后第 1 天的血清钙和 PTH 水平也更好，钙补充的需要也更少。令人惊讶的是，荧光技术的使用并没有延长手术时间，反而缩短了住院时间。多变量分析显示，荧光显著降低了术后甲状旁腺功能障碍的风险，而年龄、BMI 和术前钙水平等因素则无显著相关性。
本研究表明，荧光技术可改善甲状腺手术中甲状旁腺功能的保留，从而改善短期结局并减少术后并发症。这些发现强调了荧光作为甲状旁腺功能减退管理中一种有价值工具的潜力。需要进一步的研究和验证来确立荧光技术在甲状腺中的常规应用。
