荧光显像策略在甲状腺手术中识别甲状旁腺的网状meta分析

鲁登伟; 殷素鹏; 杨泽宇; 袁钰泉; 潘彬; 张帆

doi:10.11659/jjssx.12E022139

您当前的位置：

首页 >

文章列表页 >

荧光显像策略在甲状腺手术中识别甲状旁腺的网状meta分析

临床研究 | 更新时间：2023-04-24

- 荧光显像策略在甲状腺手术中识别甲状旁腺的网状meta分析
- Network meta-analysis of fluorescence imaging strategies in the identification of parathyroid glands during thyroid surgery
- 局解手术学杂志 2023年32卷第4期页码：313-317
- 作者机构：
  
  1.重庆医科大学研究生院，重庆 400042
  2.中国科学院重庆绿色智能技术研究院，重庆 400714
  3.中国科学院大学重庆学院，重庆 400714
  4.重庆市人民医院乳腺甲状腺外科，重庆 401147
- 作者简介：
  
  张帆，E-mail：zhangfancgh@163.com
- 基金信息：
  
  重庆市技术创新与应用发展专项社发领域重点项目(CSTB2022TIAD-KPX0177);重庆市渝中区基础研究与前沿探索项目(20210162)
- DOI：10.11659/jjssx.12E022139
  中图分类号： R61
- 纸质出版日期：2023-04-25，
  
  收稿日期：2022-12-27，
扫描看全文
鲁登伟,殷素鹏,杨泽宇等.荧光显像策略在甲状腺手术中识别甲状旁腺的网状meta分析[J].局解手术学杂志,2023,32(04):313-317.

LU Deng-wei,YIN Su-peng,YANG Ze-yu,et al.Network meta-analysis of fluorescence imaging strategies in the identification of parathyroid glands during thyroid surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(04):313-317.
鲁登伟,殷素鹏,杨泽宇等.荧光显像策略在甲状腺手术中识别甲状旁腺的网状meta分析[J].局解手术学杂志,2023,32(04):313-317. DOI： 10.11659/jjssx.12E022139.

LU Deng-wei,YIN Su-peng,YANG Ze-yu,et al.Network meta-analysis of fluorescence imaging strategies in the identification of parathyroid glands during thyroid surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(04):313-317. DOI： 10.11659/jjssx.12E022139.

摘要

目的

使用网状meta分析系统性评价甲状腺手术中自体荧光（AF）和吲哚菁绿荧光（ICGF）两种荧光显像策略在甲状旁腺识别中的作用。

方法

检索PubMed、Cochrane Library、EMBASE、Web of Science、中国知网数据库，搜集在甲状腺手术中使用甲状旁腺荧光显像策略和裸眼（NE）识别的对照研究，检索截至2022年11月。由2名研究人员独立进行文献检索、筛选、数据提取以及文献质量和偏倚风险评价。使用Stata 16.0对所得文献进行网状meta分析。

结果

共检出文献743篇，最终纳入27项研究，包括3 875例患者。网状meta分析表明：在提高甲状旁腺识别率方面，AF>ICGF>NE;在降低甲状旁腺功能减退发生率方面，ICGF>AF>NE;在降低甲状旁腺自体移植率方面，AF>NE>ICGF。

结论

不同甲状旁腺荧光显像策略优势不同，但总体都有助于术中甲状旁腺识别，在降低术后甲状旁腺功能减退发生率方面具有重要意义。

Abstract

Objective

To evaluate the role of autofluorescence（AF） and indocyanine green fluorescence （ICGF） in parathyroid glands identification during thyroid surgery through network meta-analysis.

Methods

PubMed，Cochrane Library，EMBASE，Web of Science，and China National Knowledge Infrastructure databases were searched for controlled studies of fluorescence imaging strategies and naked eye （NE） in parathyroid glands identification during thyroid surgery up to November 2022. Literature search，screening，data extraction，literature quality and bias risk assessment were conducted independently by two researchers. Stata 16.0 was used to conduct a network meta-analysis of the literatures.

Results

A total of 743 literatures were detected，and 27 studies were finally included，including 3 875 patients.Network meta-analysis results showed that： in terms of improving the rate of parathyroid glands identification，AF>ICGF>NE； in terms of reducing the incidence of hypoparathyroidism，ICGF>AF>NE；in terms of reducing the rate of parathyroid glands auto-transplantation，AF>NE>ICGF.

Conclusion

Different fluorescence imaging strategies for parathyroid glands identification have respective superiorities，they are generally beneficial for intraoperative parathyroid glands identification and are of important significance in reducing the incidence of postoperative hypoparathyroidism.

关键词

甲状旁腺自体荧光吲哚菁绿荧光甲状腺手术网状meta分析

Keywords

parathyroid glandautofluorescenceindocyanine green fluorescencethyroid surgerynetwork meta-analysis

references

Waseem T，Ahmed SZ，Baig H，et al.Truncal vs. branch ligation of inferior thyroid arteries in total thyroidectomy：does it affect postoperative hypoparathyroidism？［J］.Otolaryngol Head Neck Surg，2021，164（4）：759-766.doi：10.1177/0194599820957283http://dx.doi.org/10.1177/0194599820957283.

Orloff LA，Wiseman SM，Bernet VJ，et al.American thyroid association statement on postoperative hypoparathyroidism：diagnosis，prevention，and management in adults［J］.Thyroid，2018，28（7）：830-841.doi：10.1089/thy.2017.0309http://dx.doi.org/10.1089/thy.2017.0309.

Brandi ML，Bilezikian JP，Shoback D，et al.Management of hypoparathyroidism：summary statement and guidelines［J］.J Clin Endocrinol Metabol，2016，101（6）：2273-2283.doi：10.1210/jc.2015-3907http://dx.doi.org/10.1210/jc.2015-3907.

Koimtzis GD，Stefanopoulos L，Giannoulis K，et al.What are the real rates of temporary hypoparathyroidism following thyroidectomy？ It is a matter of definition：a systematic review［J］.Endocrine，2021，73（1）：1-7.doi：10.1007/s12020-021-02663-8http://dx.doi.org/10.1007/s12020-021-02663-8.

Giordano D，Botti C，Piana S，et al.Postoperative hypoparathyroidism after completion thyroidectomy for well-differentiated thyroid cancer［J］.Eur J Endocrinol，2021，185（3）：413-419.doi：10.1530/EJE-21-0353http://dx.doi.org/10.1530/EJE-21-0353.

Demarchi MS，Karenovics W，Bédat B，et al.Intraoperative autofluorescence and indocyanine green angiography for the detection and preservation of parathyroid glands［J］.J Clin Med，2020，9（3）：830.doi：10.3390/jcm9030830http://dx.doi.org/10.3390/jcm9030830.

DiMarco A，Chotalia R，Bloxham R，et al.Does fluoroscopy prevent inadvertent parathyroidectomy in thyroid surgery？［J］.Ann R Coll Surg Engl，2019，101（7）：508-513.doi：10.1308/rcsann.2019.0065http://dx.doi.org/10.1308/rcsann.2019.0065.

Rudin AV，McKenzie TJ，Thompson GB，et al.Evaluation of parathyroid glands with indocyanine green fluorescence angiography after thyroidectomy［J］.World J Surg，2019，43（6）：1538-1543.doi：10.1007/s00268-019-04909-zhttp://dx.doi.org/10.1007/s00268-019-04909-z.

Kahramangil B，Dip F，Benmiloud F，et al.Detection of parathyroid autofluorescence using near-infrared imaging：a multicenter analysis of concordance between different surgeons［J］.Ann Surg Oncol，2018，25（4）：957-962.doi：10.1245/s10434-018-6364-2http://dx.doi.org/10.1245/s10434-018-6364-2.

Kahramangil B，Berber E.Comparison of indocyanine green fluorescence and parathyroid autofluorescence imaging in the identification of parathyroid glands during thyroidectomy［J］.Gland Surg，2017，6（6）：644-648.doi：10.21037/gs.2017.09.04http://dx.doi.org/10.21037/gs.2017.09.04.

Kim DH，Kim SW，Kang P，et al.Near-infrared autofluorescence imaging may reduce temporary hypoparathyroidism in patients undergoing total thyroidectomy and central neck dissection［J］.Thyroid，2021，31（9）：1400-1408.doi：10.1089/thy.2021.0056http://dx.doi.org/10.1089/thy.2021.0056.

Benmiloud F，Godiris-Petit G，Gras R，et al.Association of autofluorescence-based detection of the parathyroid glands during total thyroidectomy with postoperative hypocalcemia risk［J］.JAMA Surg，2020，155（2）：106.doi：10.1001/jamasurg.2019.4613http://dx.doi.org/10.1001/jamasurg.2019.4613.

Benmiloud F，Rebaudet S，Varoquaux A，et al.Impact of autofluorescence-based identification of parathyroids during total thyroidectomy on postoperative hypocalcemia：a before and after controlled study［J］.Surgery，2018，163（1）：23-30.doi：10.1016/j.surg.2017.06.022http://dx.doi.org/10.1016/j.surg.2017.06.022.

Ouyang H，Wang B，Sun B，et al.Application of indocyanine green angiography in bilateral axillo-breast approach robotic thyroidectomy for papillary thyroid cancer［J］.Front Endocrinol （Lausanne），2022，13：916557.doi：10.3389/fendo.2022.916557http://dx.doi.org/10.3389/fendo.2022.916557.

Yu HW，Chung JW，Yi JW，et al.Intraoperative localization of the parathyroid glands with indocyanine green and Firefly（R） technology during BABA robotic thyroidectomy［J］.Surg Endosc，2017，31（7）：3020-3027.doi：10.1007/s00464-016-5330-yhttp://dx.doi.org/10.1007/s00464-016-5330-y.

Quéré J，Potard G，Le Pennec R，et al.Limited contribution of indocyanine green （ICG） angiography for the detection of parathyroid glands and their vascularization during total thyroidectomy：a STROBE observational study［J］.Eur Ann Otorhinolaryngol Head Neck Dis，2022，139（5）：275-279.doi：10.1016/j.anorl. 2022.02.004http://dx.doi.org/10.1016/j.anorl.2022.02.004.

Vidal FJ，Belfontali V，Sadowski SM，et al.Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery［J］.Br J Surg，2016，103（5）：537-543.doi：10.1002/bjs.10101http://dx.doi.org/10.1002/bjs.10101.

Pastoricchio M，Bernardi S，Bortul M，et al.Autofluorescence of parathyroid glands during endocrine surgery with minimally invasive technique［J］.J Endocrinol Invest，2022，45（7）：1393-1403.doi：10.1007/s40618-022-01774-xhttp://dx.doi.org/10.1007/s40618-022-01774-x.

Lerchenberger M，Al Arabi N，Gallwas JKS，et al.Intraoperative nearinfrared autofluorescence and indocyanine green imaging to identify parathyroid glands：a comparison［J］.Int J Endocrinol，2019，2019：1-7.doi：10.1155/2019/4687951http://dx.doi.org/10.1155/2019/4687951.

Yin S，Pan B，Yang Z，et al.Combined use of autofluorescence and indocyanine green fluorescence imaging in the identification and evaluation of parathyroid glands during total thyroidectomy：a randomized controlled trial［J］.Front Endocrinol，2022，13：897797.doi：10.3389/fendo.2022.897797http://dx.doi.org/10.3389/fendo.2022.897797.

Papavramidis TS，Anagnostis P，Chorti A，et al.Do near-infrared intra-operative findings obtained using indocyanine green correlate with post-thyroidectomy parathyroid function？ The icgpredict study［J］.Endocrine Practice，2020，26（9）：967-973.doi：10.4158/EP-2020-0119http://dx.doi.org/10.4158/EP-2020-0119.

Liang T，Wang K，Wang N，et al.Indocyanine green angiography for parathyroid gland evaluation during transoral endoscopic thyroidectomy［J］.J Pers Med，2021，11（9）：843.doi：10.3390/jpm11090843http://dx.doi.org/10.3390/jpm11090843.

Kim YS，Erten O，Kahramangil B，et al.The impact of near infrared fluorescence imaging on parathyroid function after total thyroidectomy［J］.J Surg Oncol，2020，122（5）：973-979.doi：10.1002/jso.26098http://dx.doi.org/10.1002/jso.26098.

韦树建，郑桂彬，刘洋，等.甲状旁腺自体荧光在甲状腺癌根治手术中的临床应用［J］.中国耳鼻咽喉头颈外科，2020，27（8）：446-450.doi：10.16066/j.1672-7002.2020.08.007http://dx.doi.org/10.16066/j.1672-7002.2020.08.007.

王涛.近红外荧光技术对术中甲状旁腺的识别及临床意义［D］.郑州：郑州大学，2020.doi：10.27466/d.cnki.gzzdu. 2020.003328http://dx.doi.org/10.27466/d.cnki.gzzdu.2020.003328.

柳桢，殷德涛，王涛，等.近红外荧光系统对甲状腺术中甲状旁腺识别临床应用研究［J］.中国实用外科杂志，2020，40（2）：230-234.doi：10.19538/j.cjps.issn1005-2208.2020.02.20http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2020.02.20.

张颖超，陈承坤，伍波，等.近红外自体荧光成像对术中甲状旁腺实时识别的初步研究［J］.临床外科杂志，2021，29（7）：646-651.doi：10.3969 /j.issn.1005-6483.2021.07.016http://dx.doi.org/10.3969/j.issn.1005-6483.2021.07.016.

任正君.吲哚菁绿（ICG）荧光显像在甲状腺手术中保护甲状旁腺和预测术后低钙血症的应用［D］.石家庄：河北医科大学，2021.doi：10.27111/d.cnki.ghyku.2021.000731http://dx.doi.org/10.27111/d.cnki.ghyku.2021.000731.

黄俊伟，郭伟，张洋，等.近红外自体荧光显像在甲状腺癌手术中原位保留甲状旁腺的应用观察［J］.中华肿瘤防治杂志，2021，28（19）：1482-1487.doi：10.16073/j.cnki.cjcpt. 2021.19.09http://dx.doi.org/10.16073/j.cnki.cjcpt.2021.19.09.

许怀生.术中近红外成像技术识别中央区淋巴结标本中甲状旁腺的探讨［D］.合肥：安徽医科大学，2021.doi： 10.26921/d.cnki.ganyu.2021.000760http://dx.doi.org/10.26921/d.cnki.ganyu.2021.000760.

皮启飞，殷素鹏，孙乙曾，等.吲哚菁绿荧光成像技术用于甲状腺全切除术中甲状旁腺血供判断的研究［J］.中国普外基础与临床杂志，2022，29（10）：1313-1317.doi：10.7507/1007-9424. 202206021http://dx.doi.org/10.7507/1007-9424.202206021.

费媛，赵婉君，苏安平，等.吲哚菁绿荧光显像技术在甲状腺手术中对甲状旁腺血供判断的应用［J］.中国普外基础与临床杂志，2020，27（9）：1094-1099.doi：10.7507/1007-9424.201912024http://dx.doi.org/10.7507/1007-9424.201912024.

陈志达，郗洪庆，刘培发，等.近红外自体荧光显像技术在甲状腺肿瘤手术中辅助识别甲状旁腺有效性分析［J］.中国实用外科杂志，2021，41（8）：882-885.doi：10.19538/j.cjps.issn1005-2208. 2021.08.11http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2021.08.11.

Ji YB，Song CM，Sung ES，et al.Postoperative hypoparathyroidism and the viability of the parathyroid glands during thyroidectomy［J］.Clin Exper Otorhinolaryngol，2017，10（3）：265-271.doi：10.21053/ceo.2016.00724http://dx.doi.org/10.21053/ceo.2016.00724.

Ladurner R，Sommerey S，Arabi NA，et al.Intraoperative near-infrared autofluorescence imaging of parathyroid glands［J］.Surg Endosc，2017，31（8）：3140-3145.doi：10.1007/s00464-016-5338-3http://dx.doi.org/10.1007/s00464-016-5338-3.

Parfentiev R，Grubnik V，Grubnik V，et al.Study of intraoperative indocyanine green angiography effectiveness for identification of parathyroid glands during total thyroidectomy［J］.Georgian Med News，2021（314）：26-29.

Tabei I，Fuke A，Fushimi A，et al.Determination of the optimum excitation wavelength for the parathyroid gland using a near-infrared camera［J］.Front Surg，2020，7：619859.doi：10.3389/fsurg. 2020.619859http://dx.doi.org/10.3389/fsurg.2020.619859.

Solorzano CC，Thomas G，Baregamian N，et al.Detecting the near infrared autofluorescence of the human parathyroid：hype or opportunity？［J］.Ann Surg，2020，272（6）：973-985.doi：10.1097/SLA. 0000000000003700http://dx.doi.org/10.1097/SLA.0000000000003700.

Zaidi N，Bucak E，Yazici P，et al.The feasibility of indocyanine green fluorescence imaging for identifying and assessing the perfusion of parathyroid glands during total thyroidectomy［J］.J Surg Oncol，2016，113（7）：775-778.doi：10.1002/jso.24237http://dx.doi.org/10.1002/jso.24237.

Gálvez-Pastor S，Torregrosa NM，Ríos A，et al.Prediction of hypocalcemia after total thyroidectomy using indocyanine green angiography of parathyroid glands：a simple quantitative scoring system［J］.Am J Surg，2019，218（5）：993-999.doi：10.1016/j.amjsurg.2018.12.074http://dx.doi.org/10.1016/j.amjsurg.2018.12.074.

Wong A，Wong J，Pandey PU，et al.Novel techniques for intraoperative parathyroid gland identification：a comprehensive review［J］.Expert Rev Endocrinol Metab，2020，15（6）：439-457.doi：10.1080/17446651.2020.1831913http://dx.doi.org/10.1080/17446651.2020.1831913.

Rossi L，Vasquez MC，Pieroni E，et al.Indocyanine green fluorescence and near-infrared autofluorescence may improve post-thyroidectomy parathyroid function［J］.Surgery，2022，173（1）：124-131.doi：10.1016/j.surg.2022.06.042http://dx.doi.org/10.1016/j.surg.2022.06.042.

Benmiloud F.Intraoperative mapping angiography of the parathyroid glands：description， advantages，and limits of the technique［J］.VideoEndocrinology，2021，8（2）：ve.2021.0006.doi：10.1089/ve.2021. 0006http://dx.doi.org/10.1089/ve.2021.0006.

Hope-Ross M，Yannuzzi LA，Gragoudas ES，et al.Adverse reactions due to indocyanine green［J］.Ophthalmology，1994，101（3）：529-533.doi：10.1016/s0161-6420（94）31303-0http://dx.doi.org/10.1016/s0161-6420（94）31303-0.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据