1. Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wrocław, Poland.
2. Department of Orthopedic, Oncological and Reconstructive Surgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland.
3. Department of Pediatric Neurosurgery, Medical University of Silesia, Katowice, Poland.
4. Department of General and Endoscopic Surgery, EMC Euromedicare Hospital Wroclaw, Wrocław, Poland.
5. Department of Surgery, 4th Military Teaching Hospital, 50-981 Wroclaw, Poland.
6. Division of Anesthesiologic and Surgical Nursing, Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.
7. Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland.
8. Department of General, Minimally Invasive and Trauma Surgery, Franciszek Raszeja Memorial Hospital, Poznan, Poland.
9. Department of General and Vascular Surgery, 3rd Provincial Hospital, Rybnik, Poland.
Introduction: Total thyroidectomy has become the most common thyroid procedure. This treatment method results in most postoperative hypocalcemia (PH) and hypoparathyroidism (HPT) cases due to the unwitting removal of the parathyroid glands (PTGs). Near-infrared autofluorescence (NIRAF) is a new method that helps identify PTGs. This study aimed to determine whether short-term experience with intraoperative NIRAF may influence postoperative complications after thyroidectomy.
Materials and methods: Overall, 65 patients who underwent thyroidectomy by one high-volume surgeon were enrolled in the study between March 2018 and August 2021. In August 2020, the surgeon performed four operations using the NIRAF device. After that experience, the technique of operating and preserving PTGs has been totally changed. Postoperative serum calcium (Ca) and parathormone (PTH) concentrations were measured. Using retrospective study analysis, we assessed the rate of PH and HPT.
Results: There was no statistically significant difference in Ca (p = 0.1612) and PTH (p = 0.3590) concentrations between groups operated on before and after the NIRAF experience. The serum concentrations of Ca and PTH of all patients were positively correlated (r = 0.4074; p = 0.0022) as well as the Ca concentration and age of patients (r = 0.3292; p = 0.0116), respectively.
Conclusions: These findings suggest that short-term NIRAF experience, and changing attitude to preserving PTGs does not affect thyroidectomy outcomes, even when utilized by a highly experienced high-volume thyroid surgeon. However, continuous use of NIRAF might enhance treatment outcomes, particularly for surgeons with limited experience.
Keywords: near-infrared autofluorescence, thyroidectomy, high-volume surgeon, fluobeam