Progress in identification of parathyroid gland in thyroid surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZUO Qian , WANG Gang ,  WU Linfeng

The Second Ward of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, P. R. China;

Corresponding?author：

WU Linfeng, Email: Wulinfeng1020@126.com

Keywords：

parathyroid gland; identification; total thyroidectomy; lymph node; fat; review

DOI：

10.7507/1007-9424.201907094

Video：

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Objective To summarize the latest progress of parathyroid gland identification in thyroid surgery, and to provide some reference for improving the clinical efficacy.Method The literatures about the identification of parathyroid gland in thyroid surgery in recent years were collected to make an review.Results There were many methods for identifying parathyroid gland in thyroid surgery, such as naked eye identification method, intraoperative frozen section, intraoperative staining identification method, intraoperative optical identification method, intraoperative parathyroid hormone assay, γ-detector, and histological identification, each method had its own advantages and disadvantages.Conclusion The identification of parathyroid gland does not only depend on a certain method, but also require surgeons to enhance their ability to distinguish parathyroid gland.

Citation： ZUO Qian, WANG Gang, WU Linfeng. Progress in identification of parathyroid gland in thyroid surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(3): 358-362. doi: 10.7507/1007-9424.201907094 Copy

1.	Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of hypoparathyroidism: etiologies and clinical features. J Clin Endocrinol Metab, 2016, 101(6): 2300-2312.
2.	Almquist M, Ivarsson K, Nordenstr?m E, et al. Mortality in patients with permanent hypoparathyroidism after total thyroidectomy. Br J Surg, 2018, 105(10): 1313-1318.
3.	Zhu J, Tian W, Xu Z, et al. Expert consensus statement on parathyroid protection in thyroidectomy. Ann Transl Med, 2015, 3(16): 230.
4.	中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 甲狀腺手術中甲狀旁腺保護專家共識. 中國實用外科雜志, 2015, 35(7): 731-736.
5.	中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 經胸前入路腔鏡甲狀腺手術專家共識. 中國實用外科雜志, 2017, 37(12): 1369-1373.
6.	McWade MA, Paras C, White LM, et al. A novel optical approach to intraoperative detection of parathyroid glands. Surgery, 2013, 154(6): 1371-1377.
7.	Dudley NE. Methylene blue for rapid identification of the parathyroids. Br Med J, 1971, 3(5776): 680-681.
8.	鐘琦, 房居高, 馬泓智, 等. 經靜脈低劑量亞甲藍甲狀旁腺定位在甲狀腺手術中的初步應用. 中國耳鼻咽喉頭頸外科, 2016, 23(5): 247-249.
9.	Patel HP, Chadwick DR, Harrison BJ, et al. Systematic review of intravenous methylene blue in parathyroid surgery. Br J Surg, 2012, 99(10): 1345-1351.
10.	Piromchai P, Juengtrakool T, Laohasiriwong S, et al. The sensitivity and specificity of methylene blue spray to identify the parathyroid gland during thyroidectomy. Peer J, 2019, 7: e6376.
11.	Sari S, Aysan E, Muslumanoglu M, et al. Safe thyroidectomy with intraoperative methylene blue spraying. Thyroid Res, 2012, 5(1): 15-19.
12.	朱精強, 汪洵理, 魏濤, 等. 納米碳甲狀旁腺負顯影辨認保護技術在甲狀腺癌手術中的應用. 中國普外基礎與臨床雜志, 2013, 20(9): 992-994.
13.	Yan S, Zhao W, Wang B, et al. Preoperative injection of carbon nanoparticles is beneficial to the patients with thyroid papillary carcinoma: from a prospective study of 102 cases. Medicine (Baltimore), 2018, 97(27): e11364.
14.	Liu Y, Li L, Yu J, et al. Carbon nanoparticle lymph node tracer improves the outcomes of surgical treatment in papillary thyroid cancer. Cancer Biomark, 2018, 23(2): 227-233.
15.	潘金強, 楊梅, 耿中利. 納米炭混懸液在甲狀腺癌全甲狀腺切除中央區淋巴結清掃術中的應用價值. 解放軍預防醫學雜志, 2018, 36(11): 1473-1474, 1490.
16.	Prosst RL, Gahlen J, Schnuelle P, et al. Fluorescence-guided minimally invasive parathyroidectomy: a novel surgical therapy for secondary hyperparathyroidism. Am J Kidney Dis, 2006, 48(2): 327-331.
17.	Elbassiouny S, Fadel M, Elwakil T, et al. Photodynamic diagnosis of parathyroid glands with nano-stealth aminolevulinic acid liposomes. Photodiagnosis Photodyn Ther, 2018, 21: 71-78.
18.	Kim SW, Lee HS, Lee KD. Intraoperative real-time localization of parathyroid gland with near infrared fluorescence imaging. Gland Surg, 2017, 6(5): 516-524.
19.	Suh YJ, Choi JY, Chai YJ, et al. Indocyanine green as a near-infrared fluorescent agent for identifying parathyroid glands during thyroid surgery in dogs. Surg Endosc, 2015, 29(9): 2811-2817.
20.	Sadowski SM, Vidal Fortuny J, Triponez F. A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques. Gland Surg, 2017, 6(Suppl 1): S30-S37.
21.	趙燁, 趙菁, 張俐娜, 等. 顯影技術在甲狀腺癌術中對甲狀旁腺的保護作用. 新醫學, 2018, 49(12): 847-852.
22.	Das K, Stone N, Kendall C, et al. Raman spectroscopy of parathyroid tissue pathology. Lasers Med Sci, 2006, 21(4): 192-197.
23.	Paras C, Keller M, White L, et al. Near-infrared autofluorescence for the detection of parathyroid glands. J Biomed Opt, 2011, 16(6): 067012.
24.	De Leeuw F, Breuskin I, Abbaci M, et al. Intraoperative near-infrared imaging for parathyroid gland identification by auto-fluorescence: a feasibility study. World J Surg, 2016, 40(9): 2131-2138.
25.	Ladurner R, Sommerey S, Arabi NA, et al. Intraoperative near-infrared autofluorescence imaging of parathyroid glands. Surg Endosc, 2017, 31(8): 3140-3145.
26.	Sommerey S, Al Arabi N, Ladurner R, et al. Intraoperative optical coherence tomography imaging to identify parathyroid glands. Surg Endosc, 2015, 29(9): 2698-2704.
27.	黃海燕, 李浩, 林少建, 等. 甲狀腺術中應用抽吸組織測定甲狀旁腺激素的臨床意義. 中華耳鼻咽喉頭頸外科雜志, 2013, 48(11): 934-938.
28.	Bian XH, Li SJ, Zhou L, et al. Applicability of rapid intraoperative parathyroid hormone assay through fine needle aspiration to identify parathyroid tissue in thyroid surgery. Exp Ther Med, 2016, 12(6): 4072-4076.
29.	何高飛, 高力, 宋春軼, 等. 術中甲狀旁腺辨識方法的研究進展. 中華內分泌外科雜志, 2017, 11(4): 345-348.
30.	張進軍, 夏文飛, 沈文狀, 等. 免疫膠體金法甲狀旁腺快速鑒定技術及其臨床應用價值研究. 中國實用外科雜志, 2018, 38(2): 227-230, 237.
31.	Gencoglu EA, Aktas A. The efficacy of low and high dose (99m)Tc-MIBI protocols for intraoperative identification of hyperplastic parathyroid glands in secondary hyperparathyroidism. Rev Esp Med Nucl Imagen Mol, 2014, 33(4): 210-214.
32.	陳雋, 鄭雯潔, 周秦毅, 等. 納米碳負顯像結合^99mTc-MIBI術中定位甲狀旁腺的研究. 臨床耳鼻咽喉頭頸外科雜志, 2016, 30(18): 1463-1466.
33.	Grubbs EG, Mittendorf EA, Perrier ND, et al. Gamma probe identification of normal parathyroid glands during central neck surgery can facilitate parathyroid preservation. Am J Surg, 2008, 196(6): 931-935, 935-936.
34.	Wei H, Huang M, Fan J, et al. Intraoperative rapid aspiration cytological method for parathyroid glands identification and protection. Endocr J, 2019, 66(2): 135-141.
35.	Ambe PC, Br?mling S, Knoefel WT, et al. Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients. Patient Saf Surg, 2014, 8(1): 45.
36.	孟慶輝, 王子恒, 吳偉華, 等. 甲狀旁腺術中不染色快速組織學鑒定的應用價值. 哈爾濱醫科大學學報, 2010, 44(6): 625-626.
37.	孫瑋笛, 李曉江. 甲狀腺手術中甲狀旁腺辨認及保護方法的探討. 世界最新醫學信息文摘, 2019, 19(42): 72-73, 75.
38.	朱精強, 田文, 蘇安平. 甲狀腺圍手術期甲狀旁腺功能保護指南 (2018版). 中國實用外科雜志, 2018, 38(10): 1108-1113.

1. Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of hypoparathyroidism: etiologies and clinical features. J Clin Endocrinol Metab, 2016, 101(6): 2300-2312.
2. Almquist M, Ivarsson K, Nordenstr?m E, et al. Mortality in patients with permanent hypoparathyroidism after total thyroidectomy. Br J Surg, 2018, 105(10): 1313-1318.
3. Zhu J, Tian W, Xu Z, et al. Expert consensus statement on parathyroid protection in thyroidectomy. Ann Transl Med, 2015, 3(16): 230.
4. 中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 甲狀腺手術中甲狀旁腺保護專家共識. 中國實用外科雜志, 2015, 35(7): 731-736.
5. 中國醫師協會外科醫師分會甲狀腺外科醫師委員會. 經胸前入路腔鏡甲狀腺手術專家共識. 中國實用外科雜志, 2017, 37(12): 1369-1373.
6. McWade MA, Paras C, White LM, et al. A novel optical approach to intraoperative detection of parathyroid glands. Surgery, 2013, 154(6): 1371-1377.
7. Dudley NE. Methylene blue for rapid identification of the parathyroids. Br Med J, 1971, 3(5776): 680-681.
8. 鐘琦, 房居高, 馬泓智, 等. 經靜脈低劑量亞甲藍甲狀旁腺定位在甲狀腺手術中的初步應用. 中國耳鼻咽喉頭頸外科, 2016, 23(5): 247-249.
9. Patel HP, Chadwick DR, Harrison BJ, et al. Systematic review of intravenous methylene blue in parathyroid surgery. Br J Surg, 2012, 99(10): 1345-1351.
10. Piromchai P, Juengtrakool T, Laohasiriwong S, et al. The sensitivity and specificity of methylene blue spray to identify the parathyroid gland during thyroidectomy. Peer J, 2019, 7: e6376.
11. Sari S, Aysan E, Muslumanoglu M, et al. Safe thyroidectomy with intraoperative methylene blue spraying. Thyroid Res, 2012, 5(1): 15-19.
12. 朱精強, 汪洵理, 魏濤, 等. 納米碳甲狀旁腺負顯影辨認保護技術在甲狀腺癌手術中的應用. 中國普外基礎與臨床雜志, 2013, 20(9): 992-994.
13. Yan S, Zhao W, Wang B, et al. Preoperative injection of carbon nanoparticles is beneficial to the patients with thyroid papillary carcinoma: from a prospective study of 102 cases. Medicine (Baltimore), 2018, 97(27): e11364.
14. Liu Y, Li L, Yu J, et al. Carbon nanoparticle lymph node tracer improves the outcomes of surgical treatment in papillary thyroid cancer. Cancer Biomark, 2018, 23(2): 227-233.
15. 潘金強, 楊梅, 耿中利. 納米炭混懸液在甲狀腺癌全甲狀腺切除中央區淋巴結清掃術中的應用價值. 解放軍預防醫學雜志, 2018, 36(11): 1473-1474, 1490.
16. Prosst RL, Gahlen J, Schnuelle P, et al. Fluorescence-guided minimally invasive parathyroidectomy: a novel surgical therapy for secondary hyperparathyroidism. Am J Kidney Dis, 2006, 48(2): 327-331.
17. Elbassiouny S, Fadel M, Elwakil T, et al. Photodynamic diagnosis of parathyroid glands with nano-stealth aminolevulinic acid liposomes. Photodiagnosis Photodyn Ther, 2018, 21: 71-78.
18. Kim SW, Lee HS, Lee KD. Intraoperative real-time localization of parathyroid gland with near infrared fluorescence imaging. Gland Surg, 2017, 6(5): 516-524.
19. Suh YJ, Choi JY, Chai YJ, et al. Indocyanine green as a near-infrared fluorescent agent for identifying parathyroid glands during thyroid surgery in dogs. Surg Endosc, 2015, 29(9): 2811-2817.
20. Sadowski SM, Vidal Fortuny J, Triponez F. A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques. Gland Surg, 2017, 6(Suppl 1): S30-S37.
21. 趙燁, 趙菁, 張俐娜, 等. 顯影技術在甲狀腺癌術中對甲狀旁腺的保護作用. 新醫學, 2018, 49(12): 847-852.
22. Das K, Stone N, Kendall C, et al. Raman spectroscopy of parathyroid tissue pathology. Lasers Med Sci, 2006, 21(4): 192-197.
23. Paras C, Keller M, White L, et al. Near-infrared autofluorescence for the detection of parathyroid glands. J Biomed Opt, 2011, 16(6): 067012.
24. De Leeuw F, Breuskin I, Abbaci M, et al. Intraoperative near-infrared imaging for parathyroid gland identification by auto-fluorescence: a feasibility study. World J Surg, 2016, 40(9): 2131-2138.
25. Ladurner R, Sommerey S, Arabi NA, et al. Intraoperative near-infrared autofluorescence imaging of parathyroid glands. Surg Endosc, 2017, 31(8): 3140-3145.
26. Sommerey S, Al Arabi N, Ladurner R, et al. Intraoperative optical coherence tomography imaging to identify parathyroid glands. Surg Endosc, 2015, 29(9): 2698-2704.
27. 黃海燕, 李浩, 林少建, 等. 甲狀腺術中應用抽吸組織測定甲狀旁腺激素的臨床意義. 中華耳鼻咽喉頭頸外科雜志, 2013, 48(11): 934-938.
28. Bian XH, Li SJ, Zhou L, et al. Applicability of rapid intraoperative parathyroid hormone assay through fine needle aspiration to identify parathyroid tissue in thyroid surgery. Exp Ther Med, 2016, 12(6): 4072-4076.
29. 何高飛, 高力, 宋春軼, 等. 術中甲狀旁腺辨識方法的研究進展. 中華內分泌外科雜志, 2017, 11(4): 345-348.
30. 張進軍, 夏文飛, 沈文狀, 等. 免疫膠體金法甲狀旁腺快速鑒定技術及其臨床應用價值研究. 中國實用外科雜志, 2018, 38(2): 227-230, 237.
31. Gencoglu EA, Aktas A. The efficacy of low and high dose (99m)Tc-MIBI protocols for intraoperative identification of hyperplastic parathyroid glands in secondary hyperparathyroidism. Rev Esp Med Nucl Imagen Mol, 2014, 33(4): 210-214.
32. 陳雋, 鄭雯潔, 周秦毅, 等. 納米碳負顯像結合^99mTc-MIBI術中定位甲狀旁腺的研究. 臨床耳鼻咽喉頭頸外科雜志, 2016, 30(18): 1463-1466.
33. Grubbs EG, Mittendorf EA, Perrier ND, et al. Gamma probe identification of normal parathyroid glands during central neck surgery can facilitate parathyroid preservation. Am J Surg, 2008, 196(6): 931-935, 935-936.
34. Wei H, Huang M, Fan J, et al. Intraoperative rapid aspiration cytological method for parathyroid glands identification and protection. Endocr J, 2019, 66(2): 135-141.
35. Ambe PC, Br?mling S, Knoefel WT, et al. Prolonged duration of surgery is not a risk factor for postoperative complications in patients undergoing total thyroidectomy: a single center experience in 305 patients. Patient Saf Surg, 2014, 8(1): 45.
36. 孟慶輝, 王子恒, 吳偉華, 等. 甲狀旁腺術中不染色快速組織學鑒定的應用價值. 哈爾濱醫科大學學報, 2010, 44(6): 625-626.
37. 孫瑋笛, 李曉江. 甲狀腺手術中甲狀旁腺辨認及保護方法的探討. 世界最新醫學信息文摘, 2019, 19(42): 72-73, 75.
38. 朱精強, 田文, 蘇安平. 甲狀腺圍手術期甲狀旁腺功能保護指南 (2018版). 中國實用外科雜志, 2018, 38(10): 1108-1113.

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Progress in identification of parathyroid gland in thyroid surgery

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