Clinical study on the effect of probe-type near-infrared autofluorescence detection technology in the identification and protection of parathyroid glands during total thyroidectomy

Purpose To explore the effectiveness of probe-based near-infrared autofluorescence detection technology in the identification and functional protection of parathyroid glands during total bilateral thyroidectomy. Methods A total of 144 cases of clinical data were collected from patients who underwent total bilateral thyroidectomy with bilateral central lymph node dissection due to thyroid cancer at the First Affiliated Hospital of Anhui Medical University from June 2024 to December 2024. Among them, 75 patients who used a probe-type near-infrared autofluorescence detector to identify parathyroid glands during surgery were assigned to the autofluorescence group, and 69 patients who used the negative imaging technique of nanocarbon to identify parathyroid glands were assigned to the negative imaging group. The intraoperative parathyroid gland identification rate, in-situ preservation rate, postoperative PTH level, postoperative blood calcium level, and postoperative hypoparathyroidism rate were analyzed and compared between the two groups of patients. Results A total of 284 parathyroid glands were identified during the operation in the autofluorescence group, among which 18 were suspected parathyroid tissues (identification rate: 93.67%). In the negative imaging group, 247 parathyroid glands were identified during the operation, among which 38 were suspected parathyroid glands (identification rate: 84.62%). The parathyroid gland identification rate in the autofluorescence group was significantly higher than that in the negative imaging group (P = 0.001 < 0.05). The in-situ retention rate of parathyroid glands during the operation in the autofluorescence group was higher than that in the negative imaging group (P = 0.001 < 0.05). 21 cases of postoperative hypocalcemia occurred (incidence rate: 28%) in the autofluorescence group, which was lower than that in the negative imaging group with 31 cases (incidence rate: 44.93%). The difference between the two groups was statistically significant (P = 0.035 < 0.05). In the autofluorescence group, 29 cases of postoperative transient hypoparathyroidism occurred (incidence rate: 38.67%), which was lower than 39 cases in the negative imaging group (incidence rate: 56.52%), and the difference between the two groups was statistically significant (P = 0.032 < 0.05). No cases of permanent hypoparathyroidism occurred in either group. Conclusion This type of probe-based near-infrared spectroscopy device can serve as an effective means for parathyroid protection during total thyroidectomy. Fund programs :Anhui Provincial Science and Technology Tackling Plan (202423l10050013)