• Am. J. Surg. · Nov 2019

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

    • Silvia Gálvez-Pastor, Nuria M Torregrosa, Antonio Ríos, Beatriz Febrero, Rafael González-Costea, María A García-López, María D Balsalobre, Patrícia Pastor-Pérez, Pablo Moreno, José L Vázquez-Rojas, and José M Rodríguez.
    • Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.
    • Am. J. Surg. 2019 Nov 1; 218 (5): 993-999.

    BackgroundHypocalcemia 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.MethodsThirty 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.ResultsIn 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.ConclusionsThe 4-ICG score predicts postoperative hypocalcemia and correlates well with postoperative parathyroid function in patients undergoing total thyroidectomy for multinodular goiter.Copyright © 2019 Elsevier Inc. All rights reserved.

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