The British journal of surgery
Use of autofluorescence and/or indocyanine green in thyroid surgery: recommendations by the European Society of Endocrine Surgeons (ESES)
By Van Den Heede K, Triponez F, Agcaoglu O and 8 others.
Abstract
Background
Postoperative hypoparathyroidism remains the most frequent complication after total thyroidectomy. Recently, near-infrared autofluorescence (NIRAF) imaging with or without indocyanine green (ICG) was introduced to evaluate parathyroid glands during surgery. The aim of this paper is to provide recommendations by the European Society of Endocrine Surgeons (ESES) regarding its use in thyroid surgery based on a scoping review and meta-analysis.
Methods
A working group of experts was created by the ESES. A systematic literature search was performed, using MEDLINE® (PubMed), up to 31 December 2024. Studies were included if a comparative group was used to evaluate short- and long-term postoperative hypoparathyroidism, autotransplantation rates, and/or inadvertent parathyroid gland removal. The results were pooled in a random-effects meta-analysis. Subgroup analyses were performed to assess the impact of NIRAF with or without ICG, as well as central lymph node neck dissection. Recommendations were created among all co-authors and discussed at the 11th ESES conference. A modified Delphi online voting process amongst all members approved all recommendations.