Assessing Benefits of NIRAF Detection for Identifying Parathyroid Glands During Total Thyroidectomy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 80
- 试验地点
- 2
- 主要终点
- Subjects With Transient Hypoparathyroidism.
研究概览
简要总结
This study describes a single center, randomized, single-blinded clinical trial to assess the clinical benefits of the use of near infrared autofluorescence (NIRAF) detection with an FDA-cleared device 'Parathyroid Eye (PTeye)' for identifying parathyroid glands during total thyroidectomy. It compares risk-benefits and outcomes in patients undergoing total thyroidectomy where NIRAF detection with PTeye for parathyroid identification is either used or not used.
详细描述
Inadvertent damage or excision of a healthy parathyroid gland (PG) following a total thyroidectomy (TTx) could result in transient hypocalcemia (< 6 months) in 5 - 35% of cases or permanent hypocalcemia (> 6 months) in 7% of the patients (1, 2). In both of these circumstances, patients would require calcium and active vitamin D supplementation in addition to a potentially prolonged hospital stay and/or unplanned hospital readmission adding to unnecessary burden and healthcare costs. These complications could be minimized with label-free intraoperative PG identification using near infrared autofluorescence (NIRAF) detection with a fiber-probe based approach as utilized in 'PTeye', which is medical device that was recently FDA-cleared. However, the true impact of this particular NIRAF-based approach on patient outcomes is yet to be determined
The aim of this prospective single blinded randomized study is to compare 2 groups of patients: TTx patients operated using NIRAF detection technology with PTeye as adjunct tool (NIRAF+) vs. patients operated without the adjunct technology (NIRAF-). The main objective of this study is to assess the benefit of intraoperative use of NIRAF detection technology via PTeye during TTx procedures with regard to postoperative hypocalcemia, PG identification, PG auto-transplantation and inadvertent resection rates compared to standard of care.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Single (Participant)
盲法说明
Only participants will be masked to the intervention.
入排标准
- 年龄范围
- 18 Years 至 99 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •(i) All patients eligible for total thyroidectomy (TTx), with or without lymph node dissection. (includes patients undergoing a TTx who have undergone a prior neck exploration for parathyroid disease or other but have an intact thyroid).
- •(ii) All patients undergoing completion thyroidectomy.
排除标准
- •(i) Patients with concurrent parathyroid disease.
- •(ii) Patients with incidental enlarged parathyroid discovered during TTx.
- •(iii) Patients undergoing thyroid lobectomy/partial thyroidectomy.
结局指标
主要结局
Subjects With Transient Hypoparathyroidism.
时间窗: 24-48 hours post-op
The number of subjects with hypoparathyroidism. For the transient hypoparathyroidism; the definition utilized was a serum parathyroid hormone (PTH) level \<10 pg/mL.
Patients With Hypoparathyroidism at Last Follow-up
时间窗: 2 days to 1 year after surgery
The number of subjects with hypoparathyroidism at last follow-up. Follow-up defined as PTH less than the normal institutional range.
次要结局
- Overall Average Number of Parathyroid Glands Identified With High Confidence.(Immediate (during total thyroidectomy, up to 3 hours))
- Number of Participants With Frozen Sections Sent for Analysis.(Immediate (during total thyroidectomy, up to 3 hours))
- Number of Participants With Auto-transplanted Parathyroid Glands(Immediate (during total thyroidectomy, up to 3 hours))
- Number of Participants Who Spent Nights in the Hospital After Total Thyroidectomy(0-72 hours after total thyroidectomy)
- Number of Participants With Inadvertently Resected Parathyroid Glands(Immediate (intraoperative) to 7-10 days after total thyroidectomy (pathology report))
- Number of Doctor Visits/Emergency Department Visits or Hospital Admissions(Up to 6 months after total thyroidectomy)
- Duration and Total Daily Dosage of Calcium and/or Vitamin D Supplementation After Surgery(Up to 6 months after total thyroidectomy)
研究者
Tracy S. Wang
Professor
Medical College of Wisconsin
