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dc.contributor.authorBergenfelz, Anders
dc.contributor.authorBarczynski, Marcin
dc.contributor.authorHeie, Anette
dc.contributor.authorMuth, Andreas
dc.contributor.authorPassler, Christian
dc.contributor.authorSchneider, Max
dc.contributor.authorWierzbicka, Paulina
dc.contributor.authorKonturek, Alexander
dc.contributor.authorBrauckhoff, Katrin
dc.contributor.authorElf, Anna-Karin
dc.contributor.authorDahlberg, Jakob
dc.contributor.authorHermann, Michael
dc.date.accessioned2024-08-05T09:29:32Z
dc.date.available2024-08-05T09:29:32Z
dc.date.created2023-11-29T13:15:03Z
dc.date.issued2023
dc.identifier.issn0007-1323
dc.identifier.urihttps://hdl.handle.net/11250/3144387
dc.description.abstractBackground Techniques for autofluorescence have been introduced to visualize the parathyroid glands during surgery and to reduce hypoparathyroidism after thyroidectomy. Methods This parallel multicentre RCT investigated the use of Fluobeam® LX to visualize the parathyroid glands by autofluorescence during total thyroidectomy compared with no use. There was no restriction on the indication for surgery. Patients were randomized 1 : 1 and were blinded to the group allocation. The hypothesis was that autofluorescence enables identification and protection of the parathyroid glands during thyroidectomy. The primary endpoint was the rate of low parathyroid hormone (PTH) levels the day after surgery. Results Some 535 patients were randomized, and 486 patients received an intervention according to the study protocol, 246 in the Fluobeam® LX group and 240 in the control group. Some 64 patients (26.0 per cent) in the Fluobeam® LX group and 77 (32.1 per cent) in the control group had low levels of PTH after thyroidectomy (P = 0.141; relative risk (RR) 0.81, 95 per cent c.i. 0.61 to 1.07). Subanalysis of 174 patients undergoing central lymph node clearance showed that 15 of 82 (18 per cent) in the Fluobeam® LX group and 31 of 92 (33 per cent) in the control group had low levels of PTH on postoperative day 1 (P = 0.021; RR 0.54, 0.31 to 0.93). More parathyroid glands were identified during operation in patients who had surgery with Fluobeam® LX, and fewer parathyroid glands in the surgical specimen on definitive histopathology. No specific harm related to the use of Fluobeam® LX was reported. Conclusion The use of autofluorescence during thyroidectomy did not reduce the rate of low PTH levels on postoperative day 1 in the whole group of patients. It did, however, reduce the rate in a subgroup of patients. Registration number: NCT04509011 (http://www.clinicaltrials.gov).en_US
dc.language.isoengen_US
dc.publisherOxford University Pressen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.titleImpact of autofluorescence for detection of parathyroid glands during thyroidectomy on postoperative parathyroid hormone levels: parallel multicentre randomized clinical trialen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2
dc.identifier.doi10.1093/bjs/znad278
dc.identifier.cristin2205229
dc.source.journalBritish Journal of Surgeryen_US
dc.source.pagenumber1824-1833en_US
dc.identifier.citationBritish Journal of Surgery. 2023, 110 (12), 1824-1833.en_US
dc.source.volume110en_US
dc.source.issue12en_US


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Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal