Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidism

Abstract Background Intra-operative identification of parathyroid glands is often a challenge for surgeons performing parathyroid or thyroid surgery. Parathyroid glands stimulated by near-infrared light emit autofluorescence, which allows their discrimination from all other tissues in the region, an...

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Main Authors: Carlos Serra, Luís Silveira, António Canudo, Manuel C. Lemos
Format: Article
Language:English
Published: BMC 2019-08-01
Series:BMC Surgery
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12893-019-0590-9
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author Carlos Serra
Luís Silveira
António Canudo
Manuel C. Lemos
author_facet Carlos Serra
Luís Silveira
António Canudo
Manuel C. Lemos
author_sort Carlos Serra
collection DOAJ
description Abstract Background Intra-operative identification of parathyroid glands is often a challenge for surgeons performing parathyroid or thyroid surgery. Parathyroid glands stimulated by near-infrared light emit autofluorescence, which allows their discrimination from all other tissues in the region, and this may be of value during thyroid and parathyroid surgery. In this study, we present the results of the utilization of a low-cost device developed for the identification of parathyroid glands in surgery for primary hyperparathyroidism. Case presentation In 5 patients operated in our hospital with the diagnosis of primary hyperparathyroidism and non-concordant ultrasonography and Sestamibi scan, we used a 780 nm Light Emitting Diode (LED) to stimulate the cervical area. The resulting autofluorescence was visualized with night vision goggles with a 832 nm filter assembled. In all the five patients, an easily distinguishable nodule was identified and excised, and confirmed as parathyroid adenoma by histological exam. Intra-operative PTH assay showed significant decrease compared with basal values, fulfilling the Miami Criteria for surgical success in use in our institution. Conclusion The utilization of autofluorescence for intra-operative identification of parathyroid glands may have a clinical application in surgery for primary hyperparathyroidism, being of special utility when ultrasonography and Sestamibi Scan are non concordant.
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spelling doaj.art-94aabd3616154d4592103cbf32f50cd42022-12-21T20:11:59ZengBMCBMC Surgery1471-24822019-08-011911510.1186/s12893-019-0590-9Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidismCarlos Serra0Luís Silveira1António Canudo2Manuel C. Lemos3Departamento de Cirurgia, Hospital dos SAMSFaculdade de Ciências da Saúde, Universidade da Beira InteriorDepartamento de Cirurgia, Hospital dos SAMSCICS – UBI, Health Sciences Research Centre, Universidade da Beira InteriorAbstract Background Intra-operative identification of parathyroid glands is often a challenge for surgeons performing parathyroid or thyroid surgery. Parathyroid glands stimulated by near-infrared light emit autofluorescence, which allows their discrimination from all other tissues in the region, and this may be of value during thyroid and parathyroid surgery. In this study, we present the results of the utilization of a low-cost device developed for the identification of parathyroid glands in surgery for primary hyperparathyroidism. Case presentation In 5 patients operated in our hospital with the diagnosis of primary hyperparathyroidism and non-concordant ultrasonography and Sestamibi scan, we used a 780 nm Light Emitting Diode (LED) to stimulate the cervical area. The resulting autofluorescence was visualized with night vision goggles with a 832 nm filter assembled. In all the five patients, an easily distinguishable nodule was identified and excised, and confirmed as parathyroid adenoma by histological exam. Intra-operative PTH assay showed significant decrease compared with basal values, fulfilling the Miami Criteria for surgical success in use in our institution. Conclusion The utilization of autofluorescence for intra-operative identification of parathyroid glands may have a clinical application in surgery for primary hyperparathyroidism, being of special utility when ultrasonography and Sestamibi Scan are non concordant.http://link.springer.com/article/10.1186/s12893-019-0590-9AutofluorescenceParathyroidSurgeryNear infrared
spellingShingle Carlos Serra
Luís Silveira
António Canudo
Manuel C. Lemos
Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidism
BMC Surgery
Autofluorescence
Parathyroid
Surgery
Near infrared
title Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidism
title_full Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidism
title_fullStr Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidism
title_full_unstemmed Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidism
title_short Parathyroid identification by autofluorescence – preliminary report on five cases of surgery for primary hyperparathyroidism
title_sort parathyroid identification by autofluorescence preliminary report on five cases of surgery for primary hyperparathyroidism
topic Autofluorescence
Parathyroid
Surgery
Near infrared
url http://link.springer.com/article/10.1186/s12893-019-0590-9
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