Can peroperative autofluorescence save parathyroid glands during thyroid surgery? Original study about autofluorescence screening with surgical oversight of the specimen of thyroidectomy before sending them to pathologist.

Objective: The aim of this original study was to determine the number of parathyroid glands that could have been saved and re implanted thanks to autofluorescence checking during thyroid surgery. Summary background data: Preservation of the parathyroid function reminds challenging during the thyroid surgery. These glands must be recognized and immediately autotransplant in case of devascularization. Near-infrared autofluorescence of parathyroid glands has recently been proposed to help the surgeon during his dissection. Methods: 116 thyroid lobectomies have been performed on 70 consecutive adult patients. Each specimen of lobectomy has been scanned in vitro with an autofluorescence imaging device. Every spot of autofluorescence was study by this surgeon and then by the pathologist. The pathologist proceeded to a complete study of the rest of the lobe. We compare the results of macroscopical and microscopical diagnosis. Results: On the specimens, 24 fluorescent spots have been detected: 13 considered as parathyroid tissue for the surgeon and 11 considered as non parathyroid tissue. The pathologist exactly confirmed the surgical diagnosis but discovered 15 more hidden glands. Conclusions: Autofluorescence screening of the surgical specimen of thyroidectomy with surgical oversight is safe, quick, non invasive and it can avoid the accidental removal of parathyroid glands. About sixty per cent of these glands can be save and then autotransplanted during the surgery.