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[Prevention of hypoparathyroidism with indocyanine green in transoral thyroidectomy: Pilot study]
Jorge Armando Domínguez-Rangel1, Eric Misael Saucedo-Moreno2, Marco Antonio Piscil-Salazar2
1Universidad La Salle México, Facultad Mexicana de Medicina, Departamento de Cirugía General. Ciudad de México, México.
Background:
The prevalence of hypoparathyroidism following thyroidectomy is estimated to range from 15%, with a higher incidence observed in transoral endoscopic thyroidectomy via vestibular approach (TOETVA).
Objective:
To describe the impact of intraoperative use of indocyanine green (ICG) to identify parathyroid glands in reducing postoperative hypoparathyroidism.
Material And Methods:
A pilot, observational, comparative, longitudinal, and ambispective study was conducted in a cohort of 55 patients who underwent laparoscopic thyroidectomy via TOETVA. Calcium (Ca) and parathyroid hormone (PTH) levels were compared immediately and 24 hours after surgery.
Results:
The mean age was 43.07 years (standard deviation ± 10.15). The average surgery time was 99.15 minutes (± 20.02), and the mean blood loss was 9.3 mL (± 15.9). The prevalence of biochemical postoperative hypoparathyroidism (PTH < 12 pg/mL) was 5.54%. Biochemical hypocalcemia occurred in 19 patients (34.5%), and 4 patients (7.3%) experienced clinical hypocalcemia with paresthesia. Patients were divided into 2 groups: with and without the use of ICG. No significant differences were found in the incidence of hypocalcemia or hypoparathyroidism between the 2 groups (p = 0.360 and p = 1.000, respectively).
Conclusion:
No differences were found in surgery time, blood loss, clinical hypocalcemia, or postoperative calcium and PTH levels.