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- Publisher Website: 10.21037/gs.2017.06.13
- Scopus: eid_2-s2.0-85037125301
- PMID: 29322019
- WOS: WOS:000423441300004
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Article: To identify or not to identify parathyroid glands during total thyroidectomy
Title | To identify or not to identify parathyroid glands during total thyroidectomy |
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Authors | |
Keywords | Total thyroidectomy hypoparathyroidism hypocalcemia parathyroid gland identification (PG identification) |
Issue Date | 2017 |
Publisher | AME Publishing Company. The Journal's web site is located at http://www.glandsurgery.org/index |
Citation | Gland Surgery, 2017, v. 6 n. suppl. 1, p. S20-S29 How to Cite? |
Abstract | Hypoparathyroidism is one of the most common complications after total thyroidectomy and may impose a significant burden to both the patient and clinician. The extent of thyroid resection, surgical techniques, concomitant central neck dissection, parathyroid gland (PG) autotransplantation and inadvertent parathyroidectomy have long been some of the risk factors for postoperative hypoparathyroidism. Although routine identification of PGs has traditionally been advocated by surgeons, recent evidence has suggested that perhaps identifying fewer number of in situ PGs during surgery (i.e., selective identification) may further lower the risk of hypoparathyroidism. One explanation is that visual identification may often lead to subtle damages to the nearby blood supply of the in situ PGs and that may increase the risk of hypoparathyroidism. However, it is worth highlighting the current literature supporting either approach (i.e., routine vs. selective) remains scarce and because of the significant differences in study design, inclusions, definitions and management protocol between studies, a pooled analysis on this important but controversial topic remains an impossible task. Furthermore, it is worth nothing that identification of PGs does not equal safe preservation, as some studies demonstrated that it is not the number of PGs identified, but the number of PG preserved in situ that matters. Therefore a non-invasive, objective and reliable way to localize PGs and assess their viability intra-operatively is warranted. In this aspect, modern technology such as the indocyanine green (ICG) as near-infrared fluorescent dye for real-time in situ PG perfusion monitoring may have a potential role in the future. |
Persistent Identifier | http://hdl.handle.net/10722/251482 |
ISSN | 2023 Impact Factor: 1.5 2023 SCImago Journal Rankings: 0.506 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chang, YK | - |
dc.contributor.author | Lang, HHB | - |
dc.date.accessioned | 2018-03-01T03:39:56Z | - |
dc.date.available | 2018-03-01T03:39:56Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | Gland Surgery, 2017, v. 6 n. suppl. 1, p. S20-S29 | - |
dc.identifier.issn | 2227-684X | - |
dc.identifier.uri | http://hdl.handle.net/10722/251482 | - |
dc.description.abstract | Hypoparathyroidism is one of the most common complications after total thyroidectomy and may impose a significant burden to both the patient and clinician. The extent of thyroid resection, surgical techniques, concomitant central neck dissection, parathyroid gland (PG) autotransplantation and inadvertent parathyroidectomy have long been some of the risk factors for postoperative hypoparathyroidism. Although routine identification of PGs has traditionally been advocated by surgeons, recent evidence has suggested that perhaps identifying fewer number of in situ PGs during surgery (i.e., selective identification) may further lower the risk of hypoparathyroidism. One explanation is that visual identification may often lead to subtle damages to the nearby blood supply of the in situ PGs and that may increase the risk of hypoparathyroidism. However, it is worth highlighting the current literature supporting either approach (i.e., routine vs. selective) remains scarce and because of the significant differences in study design, inclusions, definitions and management protocol between studies, a pooled analysis on this important but controversial topic remains an impossible task. Furthermore, it is worth nothing that identification of PGs does not equal safe preservation, as some studies demonstrated that it is not the number of PGs identified, but the number of PG preserved in situ that matters. Therefore a non-invasive, objective and reliable way to localize PGs and assess their viability intra-operatively is warranted. In this aspect, modern technology such as the indocyanine green (ICG) as near-infrared fluorescent dye for real-time in situ PG perfusion monitoring may have a potential role in the future. | - |
dc.language | eng | - |
dc.publisher | AME Publishing Company. The Journal's web site is located at http://www.glandsurgery.org/index | - |
dc.relation.ispartof | Gland Surgery | - |
dc.subject | Total thyroidectomy | - |
dc.subject | hypoparathyroidism | - |
dc.subject | hypocalcemia | - |
dc.subject | parathyroid gland identification (PG identification) | - |
dc.title | To identify or not to identify parathyroid glands during total thyroidectomy | - |
dc.type | Article | - |
dc.identifier.email | Lang, HHB: Blang@hku.hk | - |
dc.identifier.authority | Lang, HHB=rp01828 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.21037/gs.2017.06.13 | - |
dc.identifier.pmid | 29322019 | - |
dc.identifier.pmcid | PMC5756751 | - |
dc.identifier.scopus | eid_2-s2.0-85037125301 | - |
dc.identifier.hkuros | 284114 | - |
dc.identifier.hkuros | 274768 | - |
dc.identifier.volume | 6 | - |
dc.identifier.issue | suppl. 1 | - |
dc.identifier.spage | S20 | - |
dc.identifier.epage | S29 | - |
dc.identifier.isi | WOS:000423441300004 | - |
dc.publisher.place | Hong Kong | - |
dc.identifier.issnl | 2227-684X | - |