The aim of the present study is to evaluate the prognostic value of intra-operative indocyanine staining scoring concerning 24 hours post-operative PTH levels and the possible advantages that its' use can give in terms of clinical practice compared to conventionally operated patients.
Study objectives are: * Detecting the changes of practice in performing total thyroidectomy with ICG. * Comparing ICG-performed minimal invasive total thyroidectomy * Identifying the cut-off points that predict low PTH levels (less than 20pg/ml) * Identifying and analyzing problematic groups of patients The study is designed as a prospective observational multi-center study. Any patient that has indication for a total thyroidectomy will be considered eligible. The study will be conducted until 60 subjects are included. It is estimated that it will take up to 3 months to enroll the patients. Pre-Surgery: Procedures preformed such as routine hospital examinations, antibiotic prophylactic treatment, anticoagulant treatment and diet will be according to the standard management protocol and will be recorded for the study. The following pre-surgery information will be recorded: 1. Demographic information including: name, age, gender, ethnicity 2. Height, weight, BMI and American Society of Anesthesiologists physical status classification system (I-VI) 3. Behavioral history (Smoking, alcohol or drug use) 4. Preoperative labs (WBC, Ht, Hgb, Ca2+, P, fT3, fT4, TSH, PTH, VitD) 5. Diagnosis including clinical observations and previous imaging results 6. Pre-operative characteristics of the adenoma 7. Medications 8. Current and past history of surgical and medical comorbidities Intra-operative: The surgeon will perform the preplanned operation. The following intraoperative variables will be recorded for all patients: 1. Surgery date 2. Duration of surgery 3. Operation performed 4. Procedure related comments 5. Number and location of the visualized glands 6. Intra-operative ICG score (ranging from 1 to 3 \[5\]) for each grand Pathology data form: The following pathology data will be recorded for all patients: 1. Post-operative diagnosis including pathology report 2. Possible parathyroids excised Postoperative follow-up: Follow-up evaluation will be performed during hospitalization 1 Postoperative labs (WBC, Ht, Hgb, Ca2+, P, fT3, fT4, TSH, PTH)
Study Type
OBSERVATIONAL
Enrollment
60
Indocyanine green will be administered intravenously to patients enrolled in this study after the completion of total thyroidectomy in order to assess the visibility of parathyroid glands and to assess the possible correlation of ICG score with post-operative parathormone levels in order to predict post-thyroidectomy hypoparathyroidism.
Unit of Endocrine Surgery, Interbalkan Medical Center, Thessaloniki, Greece
Thessaloniki, Please Enter the State Or Province, Greece
1st Propedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki
Thessaloniki, Greece
Intra-operative ICG fluarangiography predicts post-operative PTH values
Whether ICG score of parathyroid glands after total thyroidectomy correlates with 24 post-operative values of PTH
Time frame: 24 hours
ICG improves the intraoperative recognizability of the parathyroids
To assess the ability of ICG flurangiography to increase recognizability of parathyroid glands during total thyroidectomy based on ICG score of the parathyroids.
Time frame: Intraoperative
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