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Prediction of hypocalcemia after total thyroidectomy using indocyanine green angiography of parathyroid glands: a simple quantitative scoring system.
摘要： Background: Hypocalcemia is one of the most common complications after total thyroidectomy. Recently, indocyanine green (ICG) angiography of the parathyroid glands (PGs) has been suggested as a reliable tool for predicting postoperative hypocalcemia. The aim of our study was to evaluate the performance of a simple quantitative score based on ICG angiography of the PGs (4-ICG score) for predicting postoperative hypocalcemia. Methods: Thirty nine consecutive patients who underwent total thyroidectomy for multinodular goiter were included. For each patient, the 4-ICG score was calculated, adding the individual viability value of the four PGs. Discrimination and correlation analyses were performed. Results: In 32/39 patients, the four PGs were identified. Patients with postoperative hypocalcemia (n=6, 19%) had a lower 4-ICG score (2.5 [1.8–3.3] vs. 4.0 [3.0–6.0]; p = .003). The 4-ICG score showed good discrimination in terms of predicting postoperative hypocalcemia (AUC=0.875 (0.710–0.965); p=.001) and a good correlation with postoperative parathyroid function. Conclusions: The 4-ICG score predicts postoperative hypocalcemia and correlates well with postoperative parathyroid function in patients undergoing total thyroidectomy for multinodular goiter.
关键词： Parathyroid hormone,Indocyanine green,Multinodular goiter.,Parathyroid,Thyroidectomy,Hypocalcemia
更新于2025-09-23 15:22:29
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Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy
摘要： Identification of the parathyroid glands during thyroid surgery may prevent their inadvertent surgical removal and thus provide a better postoperative quality of life. Nevertheless, the most common “technique” for intraoperative evaluation of perfusion of parathyroid gland tissues during thyroid surgery is visual inspection of the physical condition of tissues, e.g., their color and bleeding edges. Another technique is measurement of intact parathyroid hormone. Recently, indocyanine green-enhanced fluorescence has been used in various surgical techniques, particularly laparoscopic surgery, to improve visualization and to provide detailed anatomical information. Fluorescent optical guidance helps surgeons to avoid inadvertent tissue injury while enhancing procedural efficiency. This technique has potential use for evaluating perfusion of the parathyroid gland in real-time intraoperative angiography.
关键词： Indocyanine green (ICG),thyroidectomy,parathyroid,hypocalcemia,fluorescence
更新于2025-09-23 15:22:29