Abstract
Background
Near-infrared autofluorescence and indocyanine green fluorescence are 2 recent tools
introduced to improve postoperative parathyroid function during thyroid surgery.
Methods
We conducted a randomized prospective study. Patients undergoing total thyroidectomy
were randomly assigned either to the fluorescence group, in which near-infrared autofluorescence
and indocyanine green fluorescence were used, or to the control group. The primary
outcomes of the study were the rate of postoperative transient and symptomatic hypocalcemia.
Results
A significantly higher number of parathyroid glands were identified in the fluorescence
group (3.83 vs 3.64, P = .028). The rate of postoperative symptomatic hypocalcemia was significantly lower
in the fluorescence group (6% vs 17%, P = .015), as was the dosage (1.53 vs 1.91 g, P = .007) and the duration of calcium therapy (32.30 vs 45.66 days, P = .003). Having at least 2 well-vascularized parathyroid glands correlates to lower
rates of transient hypocalcemia (7.4% vs 21.9%, P = .037) as well as to higher serum calcium (8.70 vs 8.42 mg/dL, P = .027) and parathyroid hormone levels (19.15 vs 11.4 pg/mL, P = .0002) on postoperative day 1.
Conclusion
Near-infrared autofluorescence and indocyanine green fluorescence are novel tools
that may support the endocrine surgeon in preserving and predicting post-thyroidectomy
parathyroid gland function.
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Article info
Publication history
Published online: October 13, 2022
Accepted:
June 15,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
