Dinets A. V., Gorobeiko M. B.

THE ROLE OF FLUORESCENCE-GUIDED SURGERY FOR THE VERIFICATION OF PARATHYROID GLANDS AND RECURRENT LARYNGEAL NERVES IN THE NEAR INFRARED SPECTRUM

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About the author:

Dinets A. V., Gorobeiko M. B.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Reccurent laryngeal nerve (RLN) pulsy and damage to the parathyroid glands are considered as major complications that might be seen during surgical interventions for benign and malignant thyroid and parathyroid neoplasms. Fluorescence-guided surgery is a method that involves the use of contrast agents and fluorophore signal identification devices for intraoperative visualization of anatomical structures. A little is known about fluorescence-guided surgery for the verification of RLN and parathyroid glands. The aim of the study was to evaluate the role of fluorescence-guided surgery using two different imaging systems and indocyanine green to identify the RLN and parathyroid glands during operations for benign and malignant thyroid and parathyroid tumors. A 131 patients were indentified for the study. All operations were performed using the capsule dissection technique. Parathyroid glands were identified with the naked eye, followed by analysis of the operative field using one of the available imaging systems to detect near infrared (NIRF) signal. Indocyanine green (ICG) was used as a fluorophore. Identification of parathyroid glands using NIRAF determination was combined with indocyanine green fluorophore administration in 102 (78%) patients. In all these cases, a uniform distribution of the signal in the NIRAF was determined. RLN did not show a signal without ICG. But after the injection of contrast ICG, a clear signal was obtained in all 131 (100%) cases from RLN. Fluorescent guided surgery is promising and novel approach for the confirmation of both RLN and parathyroid gland, which is better to apply with fluorophore such as ICG. Fluorescent guided surgery is considered as an additional tool to the naked eye conformation of the RLN and parathyroid glands.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 2, 169, 196-200 pages, index UDC 616.441+616.447

DOI:

10.29254/2077-4214-2023-2-169-196-200