Will the Autofluorescence Take over Inadvertent Parathyroidectomy? Results from a Multicentre Cohort Study

Overview

Journal Updates Surg

Date 2025 Jan 17

PMID 39825021

Authors

Diego Barbieri

Pietro Indelicato

Simone De Leo

Claudia Moneta

Silvia Coccia

Giacomo Gazzano

Leone Giordano

Francesca Lira Luce

Davide Canta

Laura Fugazzola

Mario Bussi

Gianlorenzo Dionigi

Matteo Trevisan

Affiliations

Soon will be listed here.

Abstract

Background: Recently, several devices exploiting the near-infrared autofluorescence (NIR-AF) of parathyroid glands (PGs) have been developed. Nevertheless, their impact on both preserving PGs from inadvertent surgical dissection and on post-surgical hypoparathyroidism (hypoPTH) is controversial.

Methods: A retrospective study of 845 patients undergoing thyroid surgery in 2 academic tertiary centres was conducted. In 291 patients, a NIR-AF device was used during surgery to identify PGs. The characteristics of the cohort were examined. The number of PGs identified during surgery, missed PGs, auto-transplants, inadvertent parathyroidectomies, as well as the occurrence of transient and permanent hypoPTH, were analysed.

Results: The use of NIR-AF device resulted in a higher identification of PGs (92% versus 88%, p = 0.0008), and a significant reduction in the number of PGs inadvertently removed and detected on histopathological examination (4.7% versus 6.5%, p = 0.045). An increase in PG auto-transplantations was observed in the NIR-AF + group (10.4% versus 3.5%, p < 0.0001). The use of NIRAF did not significantly impact the occurrence of either transient or permanent hypoPTH.

Conclusion: Intraoperative NIR-AF detection is a promising technology to reduce incidental parathyroidectomies in thyroid surgery. The impact of this technology on the occurrence of post-surgical hypoPTH needs to be furtherly investigated.

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