Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;79(2):392-399.
doi: 10.1007/s12020-022-03222-5. Epub 2022 Oct 17.

The impact of near-infrared autofluorescence on postoperative hypoparathyroidism during total thyroidectomy: a case-control study

Diego Barbieri #  1 , Pietro Indelicato #  2   3 , Alessandro Vinciguerra  4 , Emilio Salerno  2   3 , Rosa Alessia Battista  2   3 , Federico Di Marco  5 , Leone Giordano  2   3 , Francesca Lira Luce  2   3 , Stefano Bondi  6 , Matteo Trimarchi  2   3 , Mario Bussi  2   3
Affiliations

The impact of near-infrared autofluorescence on postoperative hypoparathyroidism during total thyroidectomy: a case-control study

Diego Barbieri et al. Endocrine. 2023 Feb.

Abstract

Purpose: Near-infrared autofluorescence is a new technology in thyroid surgery to better localize and preserve parathyroid glands. The purpose of this study is to assess if the adoption of NIR-AF can improve in short-, medium-, and long-term post-operative calcium and PTH levels compared to conventional "naked eye" surgery in patients undergoing TT for benign or malignant conditions.

Methods: 134 patients undergone total thyroidectomy between January 2020 and June 2022; 67 were treated with conventional thyroidectomy, the other 67 underwent surgery adopting an autofluorescence detecting device.

Results: Significant differences were found between the two groups in percentage of patients with short-term hypocalcemia (p = 0.04) and short-term hypoparathyroidism (p = 0.011). Median short-term (p = 0.01) and medium-term (p = 0.03) PTH levels were significantly higher in autofluorescence group, while, short- (p = 0.001), medium- (p < 0.001) and long-term (p = 0.019) percentage variation of PTH levels from baseline were significantly higher in the standard-care group. Finally, the prescription of oral calcium (p < 0.01) after surgery were significantly lower in the autofluorescence group.

Conclusion: The adoption of near-infrared autofluorescence during total thyroidectomy is related to lower short-term hypocalcemia and hypoparathyroidism rates, decreased variation of post-operative PTH levels in short- and medium- and long-term, reducing the necessity of supplementation therapy with oral calcium compared to conventional surgery.

Keywords: Autofluorescence; Hypocalcemia; Hypoparathyroidism; Near-infrared autofluorescence (NIRAF); Parathyroid glands (PGs); Thyroid surgery.

PubMed Disclaimer

References

    1. L. Rosato, N. Avenia, P. Bernante et al. Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J. Surg. (2004). https://doi.org/10.1007/s00268-003-6903-1
    1. O. Edafe, R. Antakia, N. Laskar, L. Uttley, S.P. Balasubramanian, Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia. Br. J. Surg. 101(4), 307–320 (2014). https://doi.org/10.1002/bjs.9384 - DOI
    1. M.A. McWade, C. Paras, L.M. White et al. Label-free intraoperative parathyroid localization with near-infrared autofluorescence imaging. J. Clin. Endocrinol. Metab. 99(12), 4574–4580 (2014). https://doi.org/10.1210/jc.2014-2503 - DOI
    1. T.S. Papavramidis, A. Chorti, G. Tzikos et al. The effect of intraoperative autofluorescence monitoring on unintentional parathyroid gland excision rates and postoperative PTH concentrations—a single-blind randomized-controlled trial. Endocrine 72(2), 546–552 (2021). https://doi.org/10.1007/s12020-020-02599-5 - DOI
    1. S. Gourgiotis, P. Moustafellos, N. Dimopoulos, G. Papaxoinis, S. Baratsis, E. Hadjiyannakis, Inadvertent parathyroidectomy during thyroid surgery: The incidence of a complication of thyroidectomy. Langenbeck’s Arch. Surg. 391(6), 557–560 (2006). https://doi.org/10.1007/s00423-006-0079-8 - DOI

MeSH terms

LinkOut - more resources