Abstract
Background
The usefulness of incorporating near-infrared autofluorescence into the surgical workflow
of endocrine surgeons is unclear. Our aim was to develop a prospective registry and
gather expert opinion on appropriate use of this technology.
Methods
This was a prospective multicenter collaborative study of patients undergoing thyroidectomy
and parathyroidectomy at 7 academic centers. A questionnaire was disseminated among
24 participating surgeons.
Results
Overall, 827 thyroidectomy and parathyroidectomy procedures were entered into registry:
42% of surgeons found near-infrared autofluorescence useful in identifying parathyroid
glands before they became apparent; 67% correlated near-infrared autofluorescence
pattern to normal and abnormal glands; 38% of surgeons used near-infrared autofluorescence,
rather than frozen section, to confirm parathyroid tissue; and 87% and 78% of surgeons
reported near-infrared autofluorescence did not improve the success rate after parathyroidectomy
or the ability to find ectopic glands, respectively. During thyroidectomy, 66% of
surgeons routinely used near-infrared autofluorescence to rule out inadvertent parathyroidectomy.
However, only 36% and 45% felt near-infrared autofluorescence decreased inadvertent
parathyroidectomy rates and improved ability to preserve parathyroid glands during
central neck dissections, respectively.
Conclusion
This survey study identified areas of greatest potential use for near-infrared autofluorescence,
which can form the basis of future objective trials to document the usefulness of
this technology.
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Article info
Publication history
Published online: October 27, 2022
Accepted:
July 19,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
