Nguyen Van Cuong, Song Chang Myeon, Ji Yong Bae, Myung Jae Kyung, Jeong Jin Hyeok, Tae Kyung
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni- ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Department of Pathology, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea.
Eur Arch Otorhinolaryngol. 2025 Apr 7. doi: 10.1007/s00405-025-09370-4.
This study evaluates the role and effectiveness of indocyanine green (ICG) angiography in conventional thyroidectomy, comparing its outcomes with those of the naked-eye (NE) technique.
A comprehensive literature search was conducted in PubMed, EMBASE, and the Cochrane Library databases through November 2024. Meta-analyses were performed on the selected studies. We compared the rates of parathyroid gland (PG) identification, autotransplantation, hypoparathyroidism, hypocalcemia, and postoperative levels of intact parathyroid hormone (iPTH) and calcium between the ICG and NE groups.
We analyzed 29 studies involving 2,393 thyroidectomies. The PG identification rate was significantly higher in the ICG group at 84.7% (95% CI: 77.5-90.0%) than in the NE group (OR = 1.49, 95% CI: 1.26-1.79). Additionally, the rate of parathyroid autotransplantation was higher in the ICG group (OR = 2.18, 95% CI: 1.56-3.03). The transient hypoparathyroidism rate in the ICG group was 11.0% (95% CI: 5.3-21.5%), which was slightly lower than that in the NE group, although the difference was not statistically significant. Conversely, the transient hypocalcemia rate was significantly lower in the ICG group at 13.2% (95% CI: 8.6-19.6%) than in the NE group (OR = 0.50, 95% CI: 0.30-0.85). No significant differences were observed between the two groups in 1-day postoperative iPTH or calcium levels.
This meta-analysis demonstrates the superior efficacy of ICG angiography over the NE technique during thyroidectomy. ICG angiography resulted in a higher PG identification rate and significantly reduced postoperative transient hypocalcemia compared to those in the NE approach.
本研究评估吲哚菁绿（ICG）血管造影在传统甲状腺切除术中的作用和效果，并将其结果与肉眼（NE）技术的结果进行比较。
截至2024年11月，在PubMed、EMBASE和Cochrane图书馆数据库中进行了全面的文献检索。对所选研究进行荟萃分析。我们比较了ICG组和NE组之间甲状旁腺（PG）识别率、自体移植率、甲状旁腺功能减退症、低钙血症以及术后完整甲状旁腺激素（iPTH）和钙水平。
我们分析了29项涉及2393例甲状腺切除术的研究。ICG组的PG识别率显著高于NE组，分别为84.7%（95%CI：77.5 - 90.0%）和（OR = 1.49，95%CI：1.26 - 1.79）。此外，ICG组的甲状旁腺自体移植率更高（OR = 2.18，95%CI：1.56 - 3.03）。ICG组的短暂性甲状旁腺功能减退率为11.0%（95%CI：5.3 - 21.5%），略低于NE组，尽管差异无统计学意义。相反，ICG组的短暂性低钙血症率显著低于NE组，分别为13.2%（95%CI：8.6 - 19.6%）和（OR = 0.50，95%CI：0.30 - 0.85）。两组术后1天的iPTH或钙水平无显著差异。
这项荟萃分析表明，在甲状腺切除术中ICG血管造影术比NE技术具有更高的疗效。与NE方法相比，ICG血管造影术导致更高的PG识别率，并显著降低术后短暂性低钙血症的发生率。
