| Objective In recent years,hypoparathyroidism has become one of the most common complications after thyroid surgery,among which intraoperative mastectomy is an important cause of parathyroid injury.In order to effectively prevent this situation,surgeons are trying to find effective methods to identify the parathyroid gland as accurately as possible so as to reduce the risk of postoperative hypoparathyroidism effectively.In this study,a prospective randomized controlled study was conducted to compare and analyze the number and function protection of parathyroid glands in thyroid surgery by naked eye identification method and near-infrared autofluorescence imaging(NIRAF)method and to explore the clinical application value of NIRAF technology in thyroid surgery.To provide evidence for the clinical feasibility of NIRAF technique in identifying parathyroid glands during thyroid surgery.Methods In the First Department of Oncology Surgery at Cancer Hospital,General Hospital of Ning Xia Medical University,from October 1,2020 to October 1,120 patients underwent thyroid surgery,as per the inclusion and exclusion criteria.2022 Randomly dividing twenty-two cases into two groups,each containing 60 cases,was done.Using NIRAF technology,the chief surgeon employed naked eye recognition to assist the experimental group,while the control group was conducted in accordance with the customary procedure.The incidence of postoperative hypocalcemia and hypoparathyroidism was determined after three and 6 months of operation,after a comparison of parathyroid gland count and detection rate between the two groups had been conducted during the operation.The PTH and blood calcium levels were then re-examined 1 day prior to,1 day after,and 1month later.Results 1.No significant distinction in the general information between the two groups(P>0.05)was observed,which was in agreement.2.The NIRAF group’s intraoperative parathyroid detection rate during unilateral thyroidectomy was 84.6%(44/52),significantly higher than the naked eye group’s 59.5%(25/42),and the difference was statistically significant(P<0.05).The NIRAF group’s intraoperative parathyroid detection rate in bilateral thyroidectomy was 64.0%(87/136),a figure that was higher than that of the naked eye group(44.9%(70/156),and the difference was statistically significant(P<0.05).In the two groups,226 parathyroid glands were identified,with the experimental group having 131 and the control group 95-a detection rate of 69.7% and 48.0% respectively.The experimental group’s parathyroid gland detection rate was significantly greater than the control group’s,with a P value of less than 0.05.3.No noteworthy divergence in serum calcium and PTH concentrations was discerned between the two groups one day prior,three months after,and six months after the operation(P >0.05)Furthermore,no noteworthy disparity in the occurrence of hypocalcemia and hypoparathyroidism between the two groups at 3 and 6 months post-operation was seen(P>0.05)The serum calcium and PTH concentrations in the NIRAF group were higher than those in the control group on the initial day and one month post-operation,and the disparity was statistically significant(P<0.05).The NIRAF group exhibited a significantly lower rate of hypocalcemia and hypoparathyroidism than the control group on the initial day and one month post-operation,a difference that was statistically significant(P<0.05).Conclusion With the application of NIRAF technology,thyroid surgeons can identify parathyroid glands more accurately,thereby greatly improving the safety of surgery and effectively reducing the risk of postoperative hypoparathyroidism. |
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