Comparative study of different parathyroid identification schemes during secondary operation for recurrent thyroid cancer

doi:10.3877/cma.j.issn.1674-3946.2023.02.017

Abstract

Abstract:

Objective

To investigate the application of indocyanine green fluorescence imaging and negative carbon nano imaging in the identification of parathyroid glands during secondary surgery for recurrent thyroid cancer.

Methods

Fifty patients with recurrent thyroid cancer undergoing secondary surgery from January 2018 to December 2021 were selected as the study objects，and were divided into two groups with 25 patients in each group by paired grouping method. Indocyanine green fluorescence imaging technology was used in the observation group and negative carbon nanography technology was used in the control group. SPSS 20.0 software was used to complete all data analysis. Postoperative complications and other statistical data were represented by（examples）. Comparison between groups was performed by χ² test. Perioperative indicators，serum parathyroid hormone（PTH），blood calcium levels and other measurement data were represented by（

x ˉ

±s），and independent t test was performed for comparison between groups. P<0.05 was statistically significant.

Results

The accuracy of parathyroid identification in the observation group was significantly higher than that in the control group（χ²=4.635，P=0.031）. The operation cost in observation group was significantly lower than that in control group（P<0.05）. Compared with preoperative，serum PTH and blood calcium levels in 2 groups were significantly decreased 3 days and 1 month after surgery，and control group was significantly lower than observation group（P<0.05）. The total incidence of postoperative complications in observation group was significantly lower than that in control group（P<0.05），and the incidence of hypoparathyroidism was significantly lower than that in control group［1（4.0%）vs. 8（32.0%），P=0.027］.

Conclusion

Identification of parathyroid glands by indocyanine green fluorescence imaging technique during secondary surgery for recurrent thyroid cancer can improve the accuracy of parathyroid identification，reduce intraoperative injuries，and reduce the incidence of postoperative hypoparathyroid function，and has more economic advantages，which is worthy of clinical promotion.

Key words: Thyroid Neoplasms, Parathyroid Glands, Indocyanine Green, Nanotubes，Carbon

Juan Yan, Hao Shi, Yu Zhang, Jie Zhang, Mingxiang Tuo, Qing Tian, Zhiping Xu, Xiapeng Xiao. Comparative study of different parathyroid identification schemes during secondary operation for recurrent thyroid cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(02): 180-183.

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References 16

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组别	例	性别		年龄 (岁)		BMI (Kg/m²)
组别	例	男/女		年龄 (岁)		BMI (Kg/m²)
观察组	25	6/19		41.6±5.1		22.8±2.6
对照组	25	7/18		41.2±4.9		22.5±2.5
χ²/t值		0.104		0.283		0.416
P值		0.747		0.779		0.679
组别	例	首次手术	复发位置		病理类型		二次手术
组别	例	A/B/C	患侧/对侧/双侧		乳头状癌/滤泡状癌		a/b/c/d
观察组	25	11/6/8	15/7/3		22/3		15/4/3/3
对照组	25	12/6/7	18/6/1		21/4		15/4/2/4
χ²/t值		6.010	1.350		0.166		0.343
P值		0.946	0.509		0.684		0.952

组别	例	性别		年龄 (岁)		BMI (Kg/m²)
组别	例	男/女		年龄 (岁)		BMI (Kg/m²)
观察组	25	6/19		41.6±5.1		22.8±2.6
对照组	25	7/18		41.2±4.9		22.5±2.5
χ²/t值		0.104		0.283		0.416
P值		0.747		0.779		0.679
组别	例	首次手术	复发位置		病理类型		二次手术
组别	例	A/B/C	患侧/对侧/双侧		乳头状癌/滤泡状癌		a/b/c/d
观察组	25	11/6/8	15/7/3		22/3		15/4/3/3
对照组	25	12/6/7	18/6/1		21/4		15/4/2/4
χ²/t值		6.010	1.350		0.166		0.343
P值		0.946	0.509		0.684		0.952

组别	例	手术时间(min)	术中出血量(ml)		淋巴结清扫数(枚)
观察组	25	126.2±31.2	15.5±6.7		15.4±6.5
对照组	25	132.1±29.3	16.9±7.6		15.4±6.4
t值		0.693	0.679		0.033
P值		0.492	0.500		0.974
组别	例	术后住院时间(d)		手术费用(万元)
观察组	25	5.6±1.7		0.8±0.1
对照组	25	5.7±1.8		1.1±0.5
t值		0.161		12.494
P值		0.873		0.000

组别	例	手术时间(min)	术中出血量(ml)		淋巴结清扫数(枚)
观察组	25	126.2±31.2	15.5±6.7		15.4±6.5
对照组	25	132.1±29.3	16.9±7.6		15.4±6.4
t值		0.693	0.679		0.033
P值		0.492	0.500		0.974
组别	例	术后住院时间(d)		手术费用(万元)
观察组	25	5.6±1.7		0.8±0.1
对照组	25	5.7±1.8		1.1±0.5
t值		0.161		12.494
P值		0.873		0.000

组别	例	时间	PTH(pg/ml)	血钙(mmol/L)
观察组	25	术前	35.8±3.4	2.2±0.3
		术后3 d	19.7±1.9^ab	2.1±0.1^ab
		术后1月	29.8±2.7^ab	2.2±0.3^ab
对照组	25	术前	36.0±3.3	2.3±0.1
		术后3 d	15.6±1.4^a	2.0±0.1^a
		术后1月	27.3±2.5^a	2.1±0.1^a

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