Cancers (Dec 2023)

Intraoperative Parathyroid Gland Identification Using Autofluorescence Imaging in Thyroid Cancer Surgery with Central Neck Dissection: Impact on Post-Operative Hypocalcemia

  • Joanne Guerlain,
  • Ingrid Breuskin,
  • Muriel Abbaci,
  • Livia Lamartina,
  • Julien Hadoux,
  • Eric Baudin,
  • Abir Al Ghuzlan,
  • Sophie Moog,
  • Alix Marhic,
  • Adrien Villard,
  • Rais Obongo,
  • Dana M. Hartl

DOI
https://doi.org/10.3390/cancers16010182
Journal volume & issue
Vol. 16, no. 1
p. 182

Abstract

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Hypoparathyroidism is the most frequent complication in thyroid surgery. The aim of this study was to evaluate the impact of intraoperative parathyroid gland identification, using autofluorescence imaging, on the rate of post-operative (PO) hypoparathyroidism in thyroid cancer surgery. Patients undergoing total thyroidectomy with central neck dissection from 2018 to 2022 were included. A prospective cohort of 77 patients operated on using near-infrared autofluorescence (NIRAF+) with the Fluobeam® (Fluoptics, Grenoble, France) system was compared to a retrospective cohort of 94 patients (NIR−). The main outcomes were the rate of PO hypocalcemia, with three cutoffs: corrected calcium (Cac) p = 0.003, respectively). No statistically significant difference was observed for the other two thresholds. There was a lower rate of permanent hypoparathyroidism in the NIRAF+ group (5% vs. 14% in the control group), although not statistically significant (p = 0.07). NIRAF is a surgically non-invasive adjunct, and can improve patients’ outcomes for thyroid cancer surgery by reducing post-operative temporary hypoparathyroidism. Larger prospective studies are warranted to validate our findings.

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