Is the indocyanine green score an accurate predictor of postoperative parathyroid hormone level?

Article Article scientifique Article Is the indocyanine green score an accurate predictor of postoperative parathyroid hormone level? eng 2022-02-11 2022-06 author Demarchi Marco Stefano 916698 author Baccaro Maria Ilaria 839440 author Karenovics Wolfram 501317 author Bedat Benoît 565412 author Triponez Frédéric 28673 1526-1534 10.1016/j.surg.2021.12.036 35164952 0039-6060 https://www.sciencedirect.com/science/article/pii/S0039606022000034 Background: Hypoparathyroidism is common after total thyroidectomy, primarily due to inadvertent disruption of the parathyroid gland blood supply during thyroid dissection. Indocyanine green helps determine the degree of vascularization and correlates with parathyroid gland vitality. It is difficult to determine how the indocyanine green score affects postoperative parathyroid hormone levels because all 4 parathyroid glands must be evaluated during surgery. We determined whether there is a correlation between intraoperative indocyanine green score and postoperative serum parathyroid hormone levels. Methods: We retrospectively studied patients who underwent total thyroidectomy where we could identify all 4 parathyroid glands and establish a global indocyanine green score. Each parathyroid gland was scored from 0 to 2 depending on indocyanine green uptake. The global indocyanine green score was the sum of the individual scores for each gland. The scores were then correlated to parathyroid hormone and calcium levels on days 1 and 10 after surgery. Results: We included 83 patients, 11 of whom presented with postoperative transient hypoparathyroidism; all but one had an indocyanine green score lower than 4 of 8. There was a significant correlation between the global indocyanine green score and postoperative parathyroid hormone level. A global indocyanine green score >3.75 can exclude postoperative hypoparathyroidism with a true negative value of 98%. Indocyanine green angiography is a better diagnostic test to predict a postoperative transient hypoparathyroidism compared with visual perfusion scoring. Conclusion: These findings suggest that the indocyanine green score based on intraoperative indocyanine green angiography predicts parathyroid gland function. It is a valuable instrument to predict hypoparathyroidism after total thyroidectomy. Dewey 617 57 Département de chirurgie 222 false 902 Cancer du poumon et mésothéliome pleural malin 944 Surgery 171 6 d14135a7-c6d6-490c-b19e-e04e566af27e Article (Published version) Restricted 1-s2.0-S0039606022000034-main.pdf 1351784 application/pdf 9d8ffc2c-3dbf-4eca-98b0-81b483a6f1a8 Appendix Restricted ScienceDirect_files_27May2022_07-23.zip 167618 application/zip restrictedAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Is the indocyanine green score an accurate predictor of postoperative parathyroid hormone level?	Surgery			2022	268	0

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Baccaro, Maria Ilaria