Prediction of hypocalcemia after total thyroidectomy using indocyanine green angiography of parathyroid glands: A simple quantitative scoring system.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
11 2019
Historique:
received: 01 10 2018
revised: 21 12 2018
accepted: 31 12 2018
pubmed: 23 1 2019
medline: 5 3 2020
entrez: 23 1 2019
Statut: ppublish

Résumé

Hypocalcemia is one of the most common complications after total thyroidectomy. Recently, indocyanine green (ICG) angiography of the parathyroid glands (PGs) has been suggested as a reliable tool for predicting postoperative hypocalcemia. The aim of our study was to evaluate the performance of a simple quantitative score based on ICG angiography of the PGs (4-ICG score) for predicting postoperative hypocalcemia. Thirty nine consecutive patients who underwent total thyroidectomy for multinodular goiter were included. For each patient, the 4-ICG score was calculated, adding the individual viability value of the four PGs. Discrimination and correlation analyses were performed. In 32/39 patients, the four PGs were identified. Patients with postoperative hypocalcemia (n = 6, 19%) had a lower 4-ICG score (2.5 [1.8-3.3] vs. 4.0 [3.0-6.0]; p = 0.003). The 4-ICG score showed good discrimination in terms of predicting postoperative hypocalcemia (AUC = 0.875 (0.710-0.965); p = 0.001) and a good correlation with postoperative parathyroid function. The 4-ICG score predicts postoperative hypocalcemia and correlates well with postoperative parathyroid function in patients undergoing total thyroidectomy for multinodular goiter.

Sections du résumé

BACKGROUND
Hypocalcemia is one of the most common complications after total thyroidectomy. Recently, indocyanine green (ICG) angiography of the parathyroid glands (PGs) has been suggested as a reliable tool for predicting postoperative hypocalcemia. The aim of our study was to evaluate the performance of a simple quantitative score based on ICG angiography of the PGs (4-ICG score) for predicting postoperative hypocalcemia.
METHODS
Thirty nine consecutive patients who underwent total thyroidectomy for multinodular goiter were included. For each patient, the 4-ICG score was calculated, adding the individual viability value of the four PGs. Discrimination and correlation analyses were performed.
RESULTS
In 32/39 patients, the four PGs were identified. Patients with postoperative hypocalcemia (n = 6, 19%) had a lower 4-ICG score (2.5 [1.8-3.3] vs. 4.0 [3.0-6.0]; p = 0.003). The 4-ICG score showed good discrimination in terms of predicting postoperative hypocalcemia (AUC = 0.875 (0.710-0.965); p = 0.001) and a good correlation with postoperative parathyroid function.
CONCLUSIONS
The 4-ICG score predicts postoperative hypocalcemia and correlates well with postoperative parathyroid function in patients undergoing total thyroidectomy for multinodular goiter.

Identifiants

pubmed: 30665612
pii: S0002-9610(18)31264-9
doi: 10.1016/j.amjsurg.2018.12.074
pii:
doi:

Substances chimiques

Coloring Agents 0
Indocyanine Green IX6J1063HV

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

993-999

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Silvia Gálvez-Pastor (S)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.

Nuria M Torregrosa (NM)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.

Antonio Ríos (A)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Departamento de Cirugía, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain.

Beatriz Febrero (B)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Departamento de Cirugía, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain.

Rafael González-Costea (R)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.

María A García-López (MA)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.

María D Balsalobre (MD)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.

Patrícia Pastor-Pérez (P)

Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario Reina Sofía, Murcia, Spain.

Pablo Moreno (P)

Servicio de Cirugía General y Digestivo, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.

José L Vázquez-Rojas (JL)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.

José M Rodríguez (JM)

Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Departamento de Cirugía, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain. Electronic address: jmrodri@um.es.

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Classifications MeSH