S.V. Zinchenko¹, ², I.Z. Galiev¹, E.K. Kulbida¹, K.A. Petukhov¹, R.R. Akhmetshin¹
¹Kazan (Volga Region) Federal University, Kazan
²Republican Clinical Oncological Dispensary of the Ministry of Health of Tatarstan named after Prof. M.Z. Sigal, Kazan
Zinchenko Sergey Viktorovich ― MD, Associate Professor, Head of the Department of Surgery at the Institute of Fundamental Medicine and Biology Kazan (Volga Region) Federal University ,
74 Karl Marx St., Kazan, 420012, tel. +7-903-306-80-83, e-mail: zinchenkos.v@mail.ru
ORCID ID: 0000-0002-9306-3507
Abstract. Secondary and tertiary hyperparathyroidism (sHPT, tHPT) are common endocrine diseases, often occurring with severe symptoms, in most cases caused by chronic renal failure in patients on programmed hemodialysis. Today, when conservative therapy is ineffective and threshold PTH values are reached 600 pg/ml for more than 6 months, surgical removal of pathologically altered parathyroid glands is the only method of treating vHPT and tHPT. The main objective of the review is to study current trends and techniques of intraoperative visualization of the parathyroid glands, compare these methods and evaluate their effectiveness. The use of qualitatively new technologies for the diagnosis of parathyroid glands, such as identification by autofluorescence in the near infrared spectrum (NIRAF), the technique of using indocyanine green (ICG) and the method of visualization using 5-aminolevulinic acid under UV radiation, which allow, according to the authors, intraoperatively visualize the localization of parathyroid glands with more than 90% accuracy glands are subject to detailed consideration and study, which is what this study is devoted to.
Key words: Secondary and tertiary hyperparathyroidism, parathyroid gland, imaging, surgical treatment, ICG, NIRAF, 5-ALA.