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• W4313800497 abstract "Primary Hyperparathyroidism (PHPT) is a systemic pathology caused by an excessive secretion of parathyroid hormone. Parathyroidectomy is the treatment of choice in PHPT, and the success of surgery is based on precise localization of the abnormal parathyroid gland. Preoperative diagnosis makes use of imaging techniques and functional examinations, however these are insufficient in some cases for the precise location of the pathological gland. Therefore the need arises for an intraoperative localization technique.We have retrospectively analyzed 20 consecutive patients with PHPT undergoing parathyroidectomy from April 2019 to September 2021, and divided them in two groups, in base of the use of Indocyanine Green (ICG) fluorescence during the surgery.Of the twenty patients considered in the two groups, all received a preoperative ultrasound evaluation, while second level examinations were reserved for the more difficult cases, with small volume parathyroid adenomas. In the group where the fluorescence method was employed, fluorescence was especially useful in doubtful cases, allowing easier identification of the parathyroid adenoma and consequently a reduction of time and operatory risks. In two procedures using Indocyanine green, a fluorescence signal was weak.ICG represents a convenient and safe way to detect parathyroid adenomas. We found that ICG fluorescence was very useful in all patients with non-localizing preoperative imaging studies. However further investigation is needed, to demonstrate how ICGfluorescence could be a useful localization method during parathyroid surgery.Endocrine surgery, Indocyanine green, Parathyroid surgery.L’iperparatiroidismo primitivo, è una patologia sistemica causata da un’ipersecrezione di PTH, ormone paratiroideo. La paratiroidectomia è l’opzione terapeutica di scelta, e la buona riuscita dell’intervento chirurgico è senza dubbio condizionata da una esatta identificazione della ghiandola paratiroidea patologica. La diagnosi preoperatoria si serve di tecniche di imaginged esami funzionali, finalizzati ad una precisa localizzazione, tuttavia in alcuni casi la diagnostica preoperatoria risulta insoddisfacente, determinando allungamento dei tempi chirurgici e incremento morbilità dell’intervento stesso. Su questi presupposti, origina la necessità di un sistema di rilevamento intraoperatorio. Abbiamo condotto un’analisi retrospettiva, su 20 pazienti sottoposti presso la nostra struttura a paratiroidectomia, per iperparatiroidismo primitivo, in un intervallo temporale da aprile 2019 fino a settembre 2021. I pazienti sono stati suddivisi in 2 gruppi, distinti in relazione all’impiego del verde di indocianina (ICG) come marcatore intraoperatorio. La fluorescenza, è stata registrata con telecamera laparoscopica ad emissione di luce con spettro vicino agli infrarossi. Questa tecnica, ha rappresentato nel nostro studio un presidio utile e sicuro per il rilevamento degli adenomi paratiroidei. Riteniamo che la sua utilità sia maggiore nei casi, di dubbia localizzazione alla diagnostica preoperatoria. Tuttavia ulteriori studi sono necessari per dimostrare l’utilità di questa metodica." @default.
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• W4313800497 date "2022-01-01" @default.
• W4313800497 modified "2023-09-29" @default.
• W4313800497 title "Indocyanine green fluorescence angiography in parathyroidectomy for primary hyperparathyroidism." @default.
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