EVALUACIÓN DE LA VIABILIDAD INTRAOPERATORIA DE LAS GLÁNDULAS PARATIROIDES MEDIANTE ANGIOGRAFÍA CON VERDE DE INDOCIANINA EN PACIENTES SOMETIDOS A TIROIDECTOMÍA TOTAL

Abstract

Objective: To evaluate the viability of parathyroid glands using intraoperative indocyanine green (ICG) angiography and its value as a predictor of postoperative hypocalcemia following total thyroidectomy. Material and Methods: A prospective, observational, and descriptive study was conducted. Patients undergoing total thyroidectomy between February and September 2024 were included. Intraoperative evaluation of parathyroid glands was performed using ICG angiography, applying a 0-to-2 colorimetric scale to assess gland viability. Results were compared to a control group operated between February and December 2023 without the use of ICG. Postoperative calcium and parathyroid hormone (PTH) levels were measured, and clinical signs of hypocalcemia were recorded. Statistical analysis included ANOVA, with a significance level set at p<0.05. Results: Forty patients were included (19 in the ICG group, 21 in the control group). In the ICG group, successful visualization of parathyroid glands was achieved in all cases, with 65% of patients showing four glands. The incidence of hypoparathyroidism was lower in the ICG group (11%) compared to the control group (19%), though not statistically significant. Central neck dissection was associated with higher rates of hypocalcemia. Conclusions: Intraoperative angiography with ICG enables objective assessment of parathyroid gland viability. It is a safe and useful technique that contributes to reducing the risk of postoperative hypocalcemia, particularly in complex thyroid surgeries. Keywords: Total thyroidectomy, Indocyanine green, Parathyroid glands, Hypoparathyroidism, Intraoperative angiography, Hypocalcemia