Tiroidectomía total por cáncer de tiroides: AF con sistema PTeye(TM)

Tiroidectomía total por cáncer de tiroides: detección de la autofluorescencia de las glándulas paratiroides mediante el sistema PTeye(TM)

Total thyroidectomy for thyroid cancer: detection of parathyroid gland autofluorescence using the PTeye(TM) system

Carmen Sánchez García*, Julia Bernal Tirapo*, Francisco Javier Guadarrama González*, Pedro Yuste García*

* Servicio de Cirugía General, Aparato Digestivo y Trasplante de Órganos Abdominales.
     Hospital Universitario 12 de Octubre, Madrid, España.

DOI: https://doi.org/10.14679/5168

Resumen:

El hipoparatiroidismo posoperatorio es la complicación más frecuente en cirugía endocrina, siendo la variabilidad anatómica de las glándulas paratiroides (GP) y la experiencia del cirujano los principales factores relacionados. Una lesión inadvertida que comprometa la vascularización de las GP puede conllevar a una hipocalcemia postoperatoria que, prolongada en el tiempo, puede suponer consecuencias graves para el paciente. La autofluorescencia (AF) es la propiedad intrínseca que presentan las GP al ser estimuladas con longitudes de onda en el espectro del infrarrojo cercano (NIRAF) y que es utilizada en cirugía cervical para la detección y preservación de las GP. Presentamos el caso de una tiroidectomía total con linfadenectomía central bilateral por carcinoma papilar de tiroides en el que se empleó el sistema de AF basado en una sonda (PTeye [TM]).
Palabras Clave: Tiroidectomía total; glándulas paratiroides; hipoparatiroidismo; hipocalcemia; autofluorescencia.

Abstract:

Postoperative hypoparathyroidism is the most common complication of bilateral and re-operative thyroid operations. The variations in the anatomical location of the parathyroid glands (PGs) and the expertise of surgeons are the main related factors. Hypoparathyroidism results from damage or removal of the PG during thyroid surgery and may cause several symptoms, which in severe cases can be life-threatening. Near infrared autofluorescence (NIRAF) was discovered in PGs and help surgeons to identify and preserve the PGs during thyroid surgery. A total thyroidectomy with bilateral central neck dissection was performed for thyroid cancer, assisted by the probe-based system (PTeye [TM]).
Key words: Thyroidectomy; parathyroid glands; hypoparathyroidism; hipocalcemia; near-infrared; autofluorescenc.

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