Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy
Indocyanine green (ICG) angiography, a real-time intraoperative imaging technique, is associated with better parathyroid identification and functional evaluation during open thyroidectomy. However, the benefits of ICG fluorescence imaging application in transoral endoscopic thyroidectomy are not wel...
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MDPI AG
2021-08-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/11/9/843 |
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| author | Tsung-Jung Liang Kuo-Chiang Wang Nai-Yu Wang I-Shu Chen Shiuh-Inn Liu |
| author_facet | Tsung-Jung Liang Kuo-Chiang Wang Nai-Yu Wang I-Shu Chen Shiuh-Inn Liu |
| author_sort | Tsung-Jung Liang |
| collection | DOAJ |
| description | Indocyanine green (ICG) angiography, a real-time intraoperative imaging technique, is associated with better parathyroid identification and functional evaluation during open thyroidectomy. However, the benefits of ICG fluorescence imaging application in transoral endoscopic thyroidectomy are not well-documented. Consecutive patients who underwent transoral endoscopic thyroidectomy were retrospectively reviewed. Parathyroid glands were assessed with visual inspection followed by ICG angiography. The fluorescence intensity of all parathyroid glands was recorded. In total, 158 parathyroid glands from 60 patients (41 underwent lobectomy and 19 underwent total thyroidectomy) were eligible for evaluation. A total of 135 parathyroid glands (85.4%) were identified, including nine glands (5.7%) that were solely localized because of ICG angiography. Incidental parathyroidectomy occurred in 12 patients with predominant inferior gland (83.3%) and associated with central neck dissection (66.7%). Among patients receiving total thyroidectomy, patients who retained at least one well-perfused parathyroid gland had higher parathyroid hormone (PTH) level and were less likely to develop hypoparathyroidism on postoperative day one than those without any well-perfused ICG-enhanced parathyroid gland (<i>p</i> = 0.038). In addition, the duration of calcium supplementation to maintain normocalcemia was also shorter. ICG angiography is a feasible adjunct procedure for parathyroid identification and postoperative functional prediction in transoral endoscopic thyroidectomy. |
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| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T07:32:01Z |
| publishDate | 2021-08-01 |
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| series | Journal of Personalized Medicine |
| spelling | doaj.art-87bde46dd5c346019770d6903d3f89c32023-11-22T13:49:57ZengMDPI AGJournal of Personalized Medicine2075-44262021-08-0111984310.3390/jpm11090843Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic ThyroidectomyTsung-Jung Liang0Kuo-Chiang Wang1Nai-Yu Wang2I-Shu Chen3Shiuh-Inn Liu4Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, TaiwanDivision of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, TaiwanDivision of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, TaiwanDivision of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, TaiwanDivision of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, TaiwanIndocyanine green (ICG) angiography, a real-time intraoperative imaging technique, is associated with better parathyroid identification and functional evaluation during open thyroidectomy. However, the benefits of ICG fluorescence imaging application in transoral endoscopic thyroidectomy are not well-documented. Consecutive patients who underwent transoral endoscopic thyroidectomy were retrospectively reviewed. Parathyroid glands were assessed with visual inspection followed by ICG angiography. The fluorescence intensity of all parathyroid glands was recorded. In total, 158 parathyroid glands from 60 patients (41 underwent lobectomy and 19 underwent total thyroidectomy) were eligible for evaluation. A total of 135 parathyroid glands (85.4%) were identified, including nine glands (5.7%) that were solely localized because of ICG angiography. Incidental parathyroidectomy occurred in 12 patients with predominant inferior gland (83.3%) and associated with central neck dissection (66.7%). Among patients receiving total thyroidectomy, patients who retained at least one well-perfused parathyroid gland had higher parathyroid hormone (PTH) level and were less likely to develop hypoparathyroidism on postoperative day one than those without any well-perfused ICG-enhanced parathyroid gland (<i>p</i> = 0.038). In addition, the duration of calcium supplementation to maintain normocalcemia was also shorter. ICG angiography is a feasible adjunct procedure for parathyroid identification and postoperative functional prediction in transoral endoscopic thyroidectomy.https://www.mdpi.com/2075-4426/11/9/843indocyanine greenfluorescencetransoral endoscopic thyroidectomyparathyroidthyroid |
| spellingShingle | Tsung-Jung Liang Kuo-Chiang Wang Nai-Yu Wang I-Shu Chen Shiuh-Inn Liu Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy Journal of Personalized Medicine indocyanine green fluorescence transoral endoscopic thyroidectomy parathyroid thyroid |
| title | Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy |
| title_full | Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy |
| title_fullStr | Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy |
| title_full_unstemmed | Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy |
| title_short | Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy |
| title_sort | indocyanine green angiography for parathyroid gland evaluation during transoral endoscopic thyroidectomy |
| topic | indocyanine green fluorescence transoral endoscopic thyroidectomy parathyroid thyroid |
| url | https://www.mdpi.com/2075-4426/11/9/843 |
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