[Prevention of hypoparathyroidism with indocyanine green in transoral thyroidectomy: Pilot study].

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.