Diego Barbieri1, Pietro Indelicato2,3, Alessandro Vinciguerra4, Emilio Salerno2,3, Rosa Alessia Battista2,3, Federico Di Marco5, Leone Giordano2,3, Francesca Lira Luce2,3, Stefano Bondi6, Matteo Trimarchi2,3, Mario Bussi2,3. 1. Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. barbieri.diego@hsr.it. 2. Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 3. School of Medicine, Vita-Salute San Raffaele University, Milan, Italy. 4. Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France. 5. Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 6. Division of Head and Neck department, Otorhinolaryngology Unit, IRCCS Candiolo Cancer Institute, Torino, Italy.
Abstract
PURPOSE: Near-infrared autofluorescence is a new technology in thyroid surgery to better localize and preserve parathyroid glands. The purpose of this study is to assess if the adoption of NIR-AF can improve in short-, medium-, and long-term post-operative calcium and PTH levels compared to conventional "naked eye" surgery in patients undergoing TT for benign or malignant conditions. METHODS: 134 patients undergone total thyroidectomy between January 2020 and June 2022; 67 were treated with conventional thyroidectomy, the other 67 underwent surgery adopting an autofluorescence detecting device. RESULTS: Significant differences were found between the two groups in percentage of patients with short-term hypocalcemia (p = 0.04) and short-term hypoparathyroidism (p = 0.011). Median short-term (p = 0.01) and medium-term (p = 0.03) PTH levels were significantly higher in autofluorescence group, while, short- (p = 0.001), medium- (p < 0.001) and long-term (p = 0.019) percentage variation of PTH levels from baseline were significantly higher in the standard-care group. Finally, the prescription of oral calcium (p < 0.01) after surgery were significantly lower in the autofluorescence group. CONCLUSION: The adoption of near-infrared autofluorescence during total thyroidectomy is related to lower short-term hypocalcemia and hypoparathyroidism rates, decreased variation of post-operative PTH levels in short- and medium- and long-term, reducing the necessity of supplementation therapy with oral calcium compared to conventional surgery.
PURPOSE: Near-infrared autofluorescence is a new technology in thyroid surgery to better localize and preserve parathyroid glands. The purpose of this study is to assess if the adoption of NIR-AF can improve in short-, medium-, and long-term post-operative calcium and PTH levels compared to conventional "naked eye" surgery in patients undergoing TT for benign or malignant conditions. METHODS: 134 patients undergone total thyroidectomy between January 2020 and June 2022; 67 were treated with conventional thyroidectomy, the other 67 underwent surgery adopting an autofluorescence detecting device. RESULTS: Significant differences were found between the two groups in percentage of patients with short-term hypocalcemia (p = 0.04) and short-term hypoparathyroidism (p = 0.011). Median short-term (p = 0.01) and medium-term (p = 0.03) PTH levels were significantly higher in autofluorescence group, while, short- (p = 0.001), medium- (p < 0.001) and long-term (p = 0.019) percentage variation of PTH levels from baseline were significantly higher in the standard-care group. Finally, the prescription of oral calcium (p < 0.01) after surgery were significantly lower in the autofluorescence group. CONCLUSION: The adoption of near-infrared autofluorescence during total thyroidectomy is related to lower short-term hypocalcemia and hypoparathyroidism rates, decreased variation of post-operative PTH levels in short- and medium- and long-term, reducing the necessity of supplementation therapy with oral calcium compared to conventional surgery.
Authors: Lisa A Orloff; Sam M Wiseman; Victor J Bernet; Thomas J Fahey; Ashok R Shaha; Maisie L Shindo; Samuel K Snyder; Brendan C Stack; John B Sunwoo; Marilene B Wang Journal: Thyroid Date: 2018-06-29 Impact factor: 6.568
Authors: Melanie A McWade; Constantine Paras; Lisa M White; John E Phay; Carmen C Solórzano; James T Broome; Anita Mahadevan-Jansen Journal: J Clin Endocrinol Metab Date: 2014-12 Impact factor: 5.958
Authors: Roland Ladurner; Sandra Sommerey; Nora Al Arabi; Klaus K J Hallfeldt; Herbert Stepp; Julia K S Gallwas Journal: Surg Endosc Date: 2016-11-14 Impact factor: 4.584
Authors: Jens Bollerslev; Lars Rejnmark; Claudio Marcocci; Dolores M Shoback; Antonio Sitges-Serra; Wim van Biesen; Olaf M Dekkers Journal: Eur J Endocrinol Date: 2015-08 Impact factor: 6.664
Authors: Melanie A McWade; Constantine Paras; Lisa M White; John E Phay; Anita Mahadevan-Jansen; James T Broome Journal: Surgery Date: 2013-12 Impact factor: 3.982