endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg12724endoserg-12724Research ArticleОбзорReviewИнтраоперационная визуализация околощитовидных желез при эндокринной хирургииIntraoperative identification of parathyroid glands during endocrine surgeryhttps://orcid.org/0000-0002-5877-6982БубновА. А.BubnovA. A.

Бубнов Александр Андреевич, аспирант, медицинский физик

117292, г. Москва, ул. Дмитрия Ульянова, д. 11

eLibrary SPIN-код: 9380-1293

Alexander A. Bubnov, postgraduate student, medical physicist

11 Dmitriya Ulianova str., 117292, Moscow

eLibrary SPIN-код: 9380-1293

bubnov96@mail.ruhttps://orcid.org/0000-0002-3220-2438СлащукК. Ю.SlashchukK. Yu.

Слащук Константин Юрьевич, кандидат медицинских наук, врач-эндокринолог

Москва

eLibrary SPIN-код: 3079-8033

Konstantin Y. Slashchuk, MD, Cand. Sci. (Med)]

Moscow

eLibrary SPIN-код: 3079-8033

slashuk911@gmail.comhttps://orcid.org/0000-0002-3220-2438ШиршинЕ. А.ShirshinE. A.

Ширшин Евгений Александрович, кандидат физико-математических наук, старший научный сотрудник

Москва

eLibrary SPIN-код: 9159-1676

Evgeny A. Shirshin, Cand. Sci., senior researcher

Moscow

eLibrary SPIN-код: 9159-1676

eshirshin@gmail.comhttps://orcid.org/0000-0003-3234-1427ТимошенкоВ. Ю.TimoshenkoV. Yu.

Тимошенко Виктор Юрьевич, доктор физико-математических наук, профессор

Москва

eLibrary SPIN-код: 7536-2368

Victor Yu Timoshenko, Dr. Sci., professor

Moscow

eLibrary SPIN-код: 7536-2368

vtimoshe@gmail.comНациональный исследовательский ядерный университет «МИФИ», Инженерно-физический институт биомедицины; ФГБУ «НМИЦ эндокринологии» Минздрава РоссииРоссияNational Research Nuclear University «MEPhI», Engineering Physics Institute of Biomedicine; Endorcinology Research CenterRussian FederationФГБУ «НМИЦ эндокринологии» Минздрава РоссииРоссияEndorcinology Research CenterRussian FederationМосковский государственный университет им. М.В. ЛомоносоваРоссияLomonosov Moscow State UniversityRussian FederationНациональный исследовательский ядерный университет «МИФИ», Инженерно-физический институт биомедицины; Московский государственный университет им. М.В. ЛомоносоваРоссияNational Research Nuclear University «MEPhI», Engineering Physics Institute of Biomedicine; Lomonosov Moscow State UniversityRussian Federation2021070920221534147Copyright © Бубнов А.А., Слащук К.Ю., Ширшин Е.А., Тимошенко В.Ю., 20222022Бубнов А.А., Слащук К.Ю., Ширшин Е.А., Тимошенко В.Ю.Bubnov A.A., Slashchuk K.Y., Shirshin E.A., Timoshenko V.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/12724

На сегодняшний день в рейтинге распространенности эндокринопатий щитовидная железа (ЩЖ) прочно удерживает 2-е место, уступая лишь диабету. При лечении патологий, связанных с данным органом, выделяют три подхода: медикаментозный, хирургический и терапия радиоактивным йодом. Среди этих направлений хирургический метод признан наиболее эффективным, но при этом он сопряжен с наибольшими рисками возникновения осложнений. Наиболее частыми осложнениями при данном методе лечения являются повреждение возвратного гортанного нерва и непреднамеренная травматизация или удаление здоровой околощитовидной железы (ОЩЖ), которые могут повлечь за собой нежелательные эффекты: гипопаратиреоз (транзиторный или хронический) и гипокальциемию. В настоящей обзорной статье рассматриваются актуальные методы интраоперационной оптической визуализации ОЩЖ, анализируются фундаментальные основы таких методов, их преимущества и недостатки. Показано, что флуоресцентные методы в красной и ближней инфракрасной областях спектра с использованием экзогенных красителей обладают существенной значимостью для эндокринной хирургии, так как позволяют улучшить идентификацию ОЩЖ и снизить риск послеоперационных осложнений.

Nowadays, diabetes and diseases of thyroid gland take place on the first two stage in the rank of all endocrine diseases. There are 3 directions to treat thyroid glands pathologies such as: using special pills which substitute natural thyroid hormones, surgery and radioiodine therapy. It has proven that surgery of thyroid gland is the most effective method among considering upper. at The same time, it is associated with the greatest risks of complications. The most common injuries are damage to the recurrent laryngeal nerve and unintentional traumatization or removal of a healthy parathyroid gland. Parathyroid gland is a critical organ during thyroid surgery. It means that all negative reaction nearby the structure can lead to development different complications: hypoparathyroidism (transient or chronic) and hypocalcemia. In this article is considered actual methods of intraoperative optical visualization of parathyroid glans. The fundamental foundations of such methods, their advantages and disadvantages are also analyzed. It is shown that fluorescent methods in the red and near infrared regions of the spectrum using exogenous dyes have essential importance for endocrine surgery, as they allow to improve identification and reduce the risk of postoperative complications.

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The authors declare that there are no conflicts of interest present.