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孙 军, 郭 林, 康 嘉, 陶 燕, 王 箭. [Clinical application of parathyroid autofluorescence imaging in endoscopic thyroid surgery]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2023; 37:832-836. [PMID: 37828890 PMCID: PMC10803226 DOI: 10.13201/j.issn.2096-7993.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Indexed: 10/14/2023]
Abstract
Objective:To investigate the application value of near-infrared autofluorescence imaging in identifying and protecting parathyroid glands in endoscopic thyroid surgery. Methods:From May 2022 to February 2023, 158 patients who underwent endoscopic thyroid surgery in the Department of Thyroid and Breast Vascular Surgery of Guilin People's Hospital were selected. The endoscopic fluorescence camera system was used to monitor the parathyroid glands under autofluorescence during endoscopic thyroid surgery. A total of 214 pieces were collected, among which the first 15 cases that could not be preserved in situ during the operation needed to be autotransplanted or the tissue clamped parts that could not be clearly identified as parathyroid glands were sent to fast-frozen pathology to determine whether they were parathyroid glands. Results:Among the first 15 patients who could not be preserved in situ during the operation or whose anatomy could not be clearly defined, 23 parathyroid glands were detected by autofluorescence imaging, 21 parathyroid glands were confirmed by pathology, and 2 were adipose tissue, with an accuracy rate of 91.30%; 158 patients underwent surgery Blood calcium decreased 2 hours after operation compared with preoperative blood calcium(P<0.05), decreased blood calcium 5 days after operation compared with preoperative blood calcium(P<0.01), and increased slightly 5 days after the operation compared to blood calcium 2 hours after the operation, but the difference was not statistically significant(P>0.05); while comparing parathyroid hormone(PTH), PTH at 2 hours after operation decreased significantly compared with PTH before operation(P<0.01), and PTH at 5 days after operation compared with PTH before operation PTH also decreased(P<0.01), but increased compared with PTH 2 hours after operation(P=0.001). Conclusion:In laparoscopic thyroid surgery, the application of near-infrared autofluorescence imaging technology can help surgeons quickly identify and protect parathyroid glands, and reduce the incidence of permanent hypoparathyroidism. Combining autofluorescence imaging, visual anatomy recognition under magnification of laparoscope, and intraoperative frozen pathological examination "trinity" method can improve the success rate of parathyroid gland recognition.
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Affiliation(s)
- 军 孙
- 桂林市人民医院甲状腺乳腺血管外科(广西桂林,541002)Department of Thyroid Breast Vascular Surgery, Guilin People's Hospital, Guilin, 541002, China
| | - 林政 郭
- 桂林市人民医院甲状腺乳腺血管外科(广西桂林,541002)Department of Thyroid Breast Vascular Surgery, Guilin People's Hospital, Guilin, 541002, China
| | - 嘉明 康
- 桂林市人民医院甲状腺乳腺血管外科(广西桂林,541002)Department of Thyroid Breast Vascular Surgery, Guilin People's Hospital, Guilin, 541002, China
| | - 燕萍 陶
- 桂林市人民医院甲状腺乳腺血管外科(广西桂林,541002)Department of Thyroid Breast Vascular Surgery, Guilin People's Hospital, Guilin, 541002, China
| | - 箭云 王
- 桂林市人民医院甲状腺乳腺血管外科(广西桂林,541002)Department of Thyroid Breast Vascular Surgery, Guilin People's Hospital, Guilin, 541002, China
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McDow AD, Lanzotti N, Zahnd WE, MacKinney EC, Angelos P, Mellinger JD, Ganai S. Impact of Endocrinologist and Surgeon Density on Well-Differentiated Thyroid Cancer Survival. Am Surg 2022; 88:2626-2632. [PMID: 35591793 DOI: 10.1177/00031348221091958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The influence of provider density and access on well-differentiated thyroid cancer (DTC) survival is uncertain. METHODS We used the SEER18 database to study DTC patients undergoing surgery from 2000-2012. County-level endocrinologist and surgeon density were calculated. We evaluated the relationship between provider density and cause-specific survival controlling for demographic, socioeconomic, and treatment characteristics. RESULTS Median endocrinologist density was 1.4/100 000 residents, with 15.5% of patients living in a county with no endocrinologist. Survival increased by 11% for each endocrinologist/100,000 people (P = .007). Median surgeon density was 14.8/100 000 residents, with only 1.7% of patients living in a county with no general surgeon or otolaryngologist. No significant association between surgeon density and survival was identified (P = .06). Rural residence was independently associated with lower survival (P = .009). CONCLUSIONS County-level endocrinologist density is associated with improved DTC survival. Results may reflect endocrinologist expertise, earlier diagnosis, or represent surrogacy for higher county-level access to specialized care.
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Affiliation(s)
- Alexandria D McDow
- Division of Surgical Oncology, Department of Surgery, 12250Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nicholas Lanzotti
- Stritch, School of Medicine, Department of Urology, 2456Loyola University Chicago, Maywood, IL, USA
| | - Whitney E Zahnd
- South Carolina Rural and Minority Health Research Center, Arnold School of Public Health, 49112University of South Carolina, Columbia, SC, USA
| | - Erin C MacKinney
- Department of Surgery, 5232University of Wisconsin Swedish American Health System, Rockford, IL, USA
| | - Peter Angelos
- Department of Surgery and MacLean Center for Clinical Medical Ethics, 12246University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - John D Mellinger
- Department of Surgery, 12249Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Sabha Ganai
- Department of Surgery, 12281University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
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Corona G, Croce L, Sparano C, Petrone L, Sforza A, Maggi M, Chiovato L, Rotondi M. Thyroid and heart, a clinically relevant relationship. J Endocrinol Invest 2021; 44:2535-2544. [PMID: 34033065 PMCID: PMC8572180 DOI: 10.1007/s40618-021-01590-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Thyroid disorders, both overt and subclinical, are highly prevalent conditions in the general population. Although a clear relationship between overt thyroid dysfunctions and cardiovascular complications has long been established, data regarding subclinical thyroid dysfunction are by far more controversial. PURPOSE The present review will be aimed at providing a summary of most recent evidence coming from meta-analyses regarding the complex relationship between thyroid dysfunction and cardiovascular disease. CONCLUSIONS The review will summarize, in the first part, the physiopathological link between thyroid hormone imbalances and the cardiovascular system. In the second part the review will outline the evidence coming from meta-analyses regarding the cardiovascular risk related with both overt and subclinical thyroid dysfunctions. Particular attention will be put towards studies showing data stratified for patient's age, TSH levels and pre-existing cardiovascular disease. Finally, an overview regarding the effects of specific therapy for subclinical thyroid diseases in terms of amelioration of cardiovascular outcomes will be included.
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Affiliation(s)
- G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda-Usl Bologna, Bologna, Italy
| | - L Croce
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy
- PHD Course in Experimental Medicine, University of Pavia, 27100, Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy
| | - C Sparano
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - L Petrone
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - A Sforza
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda-Usl Bologna, Bologna, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - L Chiovato
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy
| | - M Rotondi
- Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy.
- Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, Italy.
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