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Background <p>This study aims to compare the efficacy of Near-infrared autofluorescence (NIRAF) and Indocyanine green (ICG) guided total thyroidectomy versus conventional identification techniques in reducing postoperative temporary hypoparathyroidism and hypocalcemia.</p> Methods <p>This prospective cohort study included 151 patients undergoing total thyroidectomy from October 2020 to December 2022. Patients were divided into two groups: the NIRAF group (<i>n</i> = 76), and the CONTROL group (<i>n</i> = 75), where conventional naked-eye identification was used. Serum calcium and parathyroid hormone (PTH) levels were assessed on the first postoperative day.</p> Results <p>The NIRAF group demonstrated a significantly higher parathyroid detection rate (68.4% vs. 34.5%, <i>p</i> &lt; 0.05). The incidence of postoperative hypoparathyroidism was significantly lower in the NIRAF group compared to the CONTROL group (14.5% vs. 28%, <i>p</i> = 0.042).</p> Conclusion <p>NIRAF-assisted parathyroid identification significantly reduces the incidence of postoperative hypoparathyroidism. This technique is particularly beneficial in patients with larger thyroid nodules and those undergoing neck dissection.</p>

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Efficacy of Near Infrared Imaging with Indocyanine Green Injection Guided Total Thyroidectomy Versus Conventional Technique in Preventing Postoperative Hypoparathyroidism

  • 期刊论文

  • 发表日期：

    2026年6月16日

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  • Lakshmi Ravunniarth Menon,
  • Snigdha Elaprolu,
  • Tejal Patel,
  • Deepak Balasubramanian,
  • Subramania Iyer,
  • Krishnakumar Thankappan

摘要

Background

This study aims to compare the efficacy of Near-infrared autofluorescence (NIRAF) and Indocyanine green (ICG) guided total thyroidectomy versus conventional identification techniques in reducing postoperative temporary hypoparathyroidism and hypocalcemia.

Methods

This prospective cohort study included 151 patients undergoing total thyroidectomy from October 2020 to December 2022. Patients were divided into two groups: the NIRAF group (n = 76), and the CONTROL group (n = 75), where conventional naked-eye identification was used. Serum calcium and parathyroid hormone (PTH) levels were assessed on the first postoperative day.

Results

The NIRAF group demonstrated a significantly higher parathyroid detection rate (68.4% vs. 34.5%, p < 0.05). The incidence of postoperative hypoparathyroidism was significantly lower in the NIRAF group compared to the CONTROL group (14.5% vs. 28%, p = 0.042).

Conclusion

NIRAF-assisted parathyroid identification significantly reduces the incidence of postoperative hypoparathyroidism. This technique is particularly beneficial in patients with larger thyroid nodules and those undergoing neck dissection.