Related Experiment Video
Updated: Jan 14, 2026
04:01
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
1.4K
Fluorescent Imaging in Thyroid Surgery to Preserve Parathyroid Function: A Systematic Review and Meta-Analysis
Matthew H Cheung1,2, Megan T Nguyen1,3, Shaun A Nguyen1
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Summary
Intraoperative fluorescent imaging during thyroid surgery improves parathyroid gland identification and significantly reduces rates of hypoparathyroidism and hypocalcemia. This technique enhances patient outcomes by minimizing complications associated with parathyroid gland injury.
Area of Science:
- Endocrinology
- Surgical Oncology
- Medical Imaging
Background:
- Thyroid surgery can lead to hypoparathyroidism and hypocalcemia, posing significant patient burdens.
- Accurate identification of parathyroid glands (PGs) is crucial to prevent these complications.
Purpose of the Study:
- To systematically review the effectiveness of intraoperative fluorescent imaging in identifying PGs during thyroid surgery.
- To assess the impact of this imaging technique on reducing iatrogenic complications like hypoparathyroidism and hypocalcemia.
Main Methods:
- A systematic literature search was performed across PubMed, Scopus, CINAHL, and Cochrane databases.
- Included studies utilized intraoperative fluorescent imaging for PG identification and reported postoperative calcium and parathyroid hormone (PTH) levels.
- Meta-analyses were conducted to compare outcomes between fluorescent imaging and conventional methods.
Main Results:
- Twenty-eight studies involving 3876 patients were analyzed.
- Fluorescent imaging significantly increased PG identification rates (86.4% vs. 70.6%) and decreased incidental parathyroidectomy (5.3% vs. 9.5%).
- Rates of short-term hypoparathyroidism (16.7% vs. 27.0%) and postoperative hypocalcemia (Day 1: 10.6% vs. 18.1%; short-term: 5.7% vs. 11.5%) were significantly lower with fluorescent imaging.
Conclusions:
- Intraoperative fluorescent imaging is effective in enhancing parathyroid gland identification during thyroid surgery.
- This technique significantly reduces the incidence of postoperative hypocalcemia and hypoparathyroidism.
- Integrating fluorescent imaging into thyroid surgery protocols can improve patient outcomes by minimizing PG-related complications.
