Objective:

To evaluate if the integration of near-infrared autofluorescence (NIRAF) imaging with carbon nanoparticle suspension (CN) enhances the identification of parathyroid glands (PG) and their functional preservation in individuals undergoing total thyroidectomy for papillary thyroid carcinoma (PTC).

Approach:

Key Findings:

• The NIRAF + CN cohort detected a greater number of PGs (91.9%) compared to the CN cohort (84.4%, p = 0.028).
• The rate of inadvertently removed PGs was lower in the NIRAF + CN cohort (5.0%) compared to the CN cohort (15.0%, p = 0.263).
• Serum PTH levels were significantly higher in the NIRAF + CN cohort on the first postoperative day (19.86 pg/mL) compared to the CN cohort (13.82 pg/mL, p = 0.010).
• Transient hypoparathyroidism occurred in 25.0% of the NIRAF + CN cohort versus 37.5% in the CN cohort (p = 0.228).
• Permanent hypoparathyroidism was noted in 2.5% of the NIRAF + CN cohort compared to 7.5% of the CN cohort (p = 0.615).
• The autotransplantation rate was 20.0% in the NIRAF + CN cohort compared to 15.0% in the CN cohort (p = 0.770).

Interpretation:

The simultaneous application of NIRAF and CN augments intraoperative PG preservation and enhances early parathyroid activity.

Limitations:

• The study was limited to a single institution, which may affect the generalizability of the results.
• The follow-up duration may not be sufficient to assess long-term outcomes of parathyroid function.

Conclusion:

The integration of NIRAF and CN techniques may improve the identification and preservation of parathyroid glands during total thyroidectomy.

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