Systematic review of intravenous methylene blue in parathyroid surgery

Patel, H. P.; Chadwick, David; Harrison, Barney; Balasubramanian, Sabapathy P

doi:10.1002/bjs.8814

Cited by 103 publications

(84 citation statements)

References 42 publications

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“…Many attempts have been made to visualize parathyroid glands intraoperatively using scintigraphy, staining agents, or fluorescence spectroscopy. So far, none of these techniques has been accepted for routine use [10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative optical coherence tomography imaging to identify parathyroid glands

et al. 2014

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OCT is capable of distinguishing between parathyroid, thyroid, and adipose tissue. An accurate differentiation between parathyroid tissue and lymph nodes was not possible. The disappointing results compared to the previous ex vivo study are related to problems handling the endoscopic probe intraoperatively. However, further refinement of this new technology may lead to OCT systems with higher resolution and intraoperative probes that are easier to handle.

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Section: Discussionmentioning

confidence: 99%

“…A different approach has been the use of staining agents such as methylene blue or 5-aminolevulinic acid (5-ALA). However, adverse effects have been described and their effectiveness to identify parathyroid glands has yet to be shown in larger clinical series [11][12][13][14].…”

mentioning

confidence: 99%

Intraoperative optical coherence tomography imaging to identify parathyroid glands

et al. 2014

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“…As reported before, IOPTH increases the success rate of parathyroid surgery [13]. Blue dyes and especially methylene blue are used intravenously for the localization of parathyroid tumors [14]. It is considered safe for humans, and side effects like local skin necrosis or systemic toxicity were directly related with the volume and concentration used [5].…”

Section: Discussionmentioning

confidence: 86%

Successful Localization of Abnormal Parathyroid Gland Using Ultrasound-Guided Methylene Blue Dye Injection in the Reoperative Neck

et al. 2014

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Persistent or recurrent hyperparathyroidism is a challenging problem for endocrine surgeons. The aim of this study was to review our experience using ultrasound-guided (US-G) methylene blue dye injection for the localization and removal of abnormal parathyroid glands in patients having primary hyperparathyroidism and previous neck surgery. Between January 2012 and May 2013, six consecutive patients with primary hyperparathyroidism (PHPT) and previous neck surgery underwent focused parathyroidectomy with the use of US-G methylene blue dye injections to localize the presumed parathyroid adenoma were included in the study. We analyzed the data of six patients who underwent reoperative parathyroid surgery using US-G methylene blue dye injection retrospectively. The dye injection was performed just prior to surgery. All patients were successfully treated for their hyperparathyroidism which was confirmed by at least 50 % drop in intraoperative parathormone level 10 min after resection. There were no complications related with US-G dye injection or with surgery. US-G methylene blue dye injection is a cheap, safe, and effective method for localization of diseased parathyroid glands and guiding surgery in the reoperative neck.

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“…Hara et al [22] reported the subtraction technique for double-phase SPECT images to detect parathyroid lesions, with a sensitivity of 90.9% (40/44), specificity of 83.3%, and an accuracy of 92.8%, while these techniques were quite useful in parathyroid lesions but not normal PGs, particularly for the small weight and size of normal PGs. Although methylene blue has been used to detect PGs and parathyroid lesions, [23,24] the postoperative toxic metabolic encephalopathy has been reported. [24] In addition, several other techniques (methoxyisobutylisonitrile scintigraphy using a gamma probe, 5-aminolevulinic acid, and optical coherence tomography) have been reported without clinical effectiveness in protection of PGs.…”

Section: Discussionmentioning

confidence: 99%

Potential role of carbon nanoparticles in protection of parathyroid glands in patients with papillary thyroid cancer

Zhu

et al. 2016

Medicine

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As a novel type of lymphatic tracer, carbon nanoparticles (CNs) were reported not to stain parathyroid glands (PGs) into black, so it may have a clinical potential in protection of PGs during thyroidectomy. The purpose of this study was to investigate the clinical application and significance of CN in protection of PGs from surrounding tissues.A total of 82 consecutive patients were enrolled into this study and were divided into CN group and control group. Parathyroid function (hypoparathyroidism and hypocalcemia) was evaluated.The identification rates of PGs (≤2) and PGs (≥3) were 24.4% and 75.6% in the CN group and 46.3% and 53.7% in the control group, respectively. The difference in the identification rates between the 2 groups was statistically significant (P = 0.038). Pathological results revealed 3 accidental PGs resection occurred in the CN group, whereas 9 accidental PGs removal occurred in the control group. The difference was statistically significant (P = 0.046). Moreover, the incidence of the patients with hypoparathyroidism was statistically significant between the 2 groups (36.6% in CN group vs 53.7% in control group, P = 0.043) at day 1, but not at day 7 (P = 0.424).CN may have a potential in protecting PGs clinically.

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Systematic review of intravenous methylene blue in parathyroid surgery

Cited by 103 publications

References 42 publications

Intraoperative optical coherence tomography imaging to identify parathyroid glands

Intraoperative optical coherence tomography imaging to identify parathyroid glands

Successful Localization of Abnormal Parathyroid Gland Using Ultrasound-Guided Methylene Blue Dye Injection in the Reoperative Neck

Potential role of carbon nanoparticles in protection of parathyroid glands in patients with papillary thyroid cancer

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