Le neuromonitoring du nerf récurrent gauche pendant la médiastinoscopie

La médiastinoscopie reste un outil important dans le staging médiastinal des cancers pulmonaires et dans le diagnostic d'autres pathologies médiastinales. Elle reste l'examen de référence en cas de discordance ou incertitude des atures examens. Le nerf récurrent gauche est à risque d'être lésé durant la médiastinoscopie. Ceci d'autant plu que cette intervention est de moins en moins pratiquée suite à l'avènement de techniques moins invasives. Le neuromonitoring du nerf récurrent s'est établi comme un standard dans la chirurgie thyroïdienne. Nous avons appliqué cette technique avec succès durant la médiastinoscopie pour identifier avec certitude et préserver ce nerf

Intraoperative Autofluorescence and Indocyanine Green Angiography for the Detection and Preservation of Parathyroid Glands

Fluorescence imaging is a well-known method for both the in vivo and in vitro identification of specific cells or tissues. This imaging tool is gaining importance in the intraoperative detection and preservation of parathyroid glands during endocrine surgery owing to the intrinsic properties of parathyroid tissue. The aim of this paper is to provide an overview of the basics of the technology, its history, and the recent surgical intraoperative applications of near-infrared imaging methods. Moreover, a literature review of the utilization of fluorescence devices in thyroid surgery suggests that the use of near-infrared imaging seems to be beneficial in reducing postoperative hypoparathyroidism, which is one of the most frequent complications of thyroid surgery

Phéochromocytome et paragangliome : que doit retenir le praticien ?

Pheochromocytomas (PHEO) and paragangliomas (PGL) are rare neuroendocrine tumors secreting catecholamines in most cases. The clinic can be very variable. Morbidity and mortality PHEO and PGL are primarily cardiovascular and haves catecholamine-mediated origin. The PHEO and PGL can sign in with a syndromic association with multiple tumors and genetic counseling is necessary in search of a germline mutation. The first step includes a diagnostic assay of metanephrine and normetanephrines. In case of positive biology a CT or MRI imaging will be needed to locate the tumor. Treatment with alpha-blocker before surgery reduces the perioperative risk. A long term follow up is recommended to detect recurrence