Determination of Parathyroid Function by Fluorescence With Indocyanine Green (ICG) After Total Thyroidectomy

Determination of Parathyroid Function by Fluorescence With Indocyanine Green (ICG) After Total Thyroidectomy

The intensity of parathyroid fluorescence that occurs after intravenous injection of indocyanine green during the performance of a total thyroidectomy correlates with postoperative parathyroid function and could be used as a diagnostic marker of postoperative hypoparathyroidism and hypocalcemia.

The main objective of the study is to compare the intensity of parathyroid fluorescence among patients who present post-thyroidectomy hypocalcemia with that of patients who do not have it. Therefore, the following points will be studied:

• To study the correlation between parathyroid vascularization (intraoperative fluorescence intensity) and postoperative glandular function (serum calcium and parathormone levels).
• To compare the surgeon's subjective assessment of parathyroid fluorescence in the groups of patients with and without postoperative hypocalcemia.
• To compare the objective assessment of parathyroid fluorescence, by using specific computer software developed ad hoc, in the groups of patients with and without postoperative hypocalcemia.

Inclusion Criteria:

• Patients who are going to undergo total thyroidectomy, with or without cervical lymph node dissection.
• Visualization of 2 or more parathyroid glands during the surgical act.
• Normal renal and hepatic functions.
• Absence of a history of hypersensitivity reactions to iodine or indocyanine green.
• Able to understand the nature and protocol of the study and its procedures
• Willingness to participate with the subsequent signing of informed consent.

Exclusion Criteria:

• Age <18 years
• Hepatic or renal insufficiency
• Hypersensitivity to iodine or to indocyanine green.
• Pregnancy or lactation
• Inability to understand the nature and procedures of the study.
• Patients with known preoperative hyperparathyroidism.