Near-infrared Fluorescence With Indocyanine Green for Identification of Sentinels and Parathyroids During Thyroidectomy
Near-infrared Fluorescence With Indocyanine Green for Identification of Sentinels and Parathyroids During Thyroidectomy
Indocyanine green (ICG) is a water-soluble organic dye that is cleared totally through the
 hepatobiliary system. It has a half-life of 3-4 mins, which allows repeated applications.
 Near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) imaging has been
 recently introduced, and has been suggested as a useful tool for the identification and
 preservation of the parathyroid glands (PGs) during total thyroidectomy (TT). ICG can also be
 used for sentinel lymph node (SLN) biopsy to predict the micrometastases in central lymph
 nodes (CLN) in thyroid carcinoma, and central lymph node dissection can reduce local
 recurrence.
Incidence of thyroid cancer has doubled between 1980 and 2020, and it is now the fifth most
 common malignant tumor among women. The majority are papillary thyroid cancer (PTC), and TT
 is the procedure of choice. Since the micrometastasis rate of the central lymph nodes (CLNs)
 is about 30% to 90% in PTC, CLN dissection can improve the prognosis and reduce tumor
 recurrence as well as provide accurate information for the evaluation of tumor staging.
 However, TT procedure has some important complications such as vocal cord paralysis (VCP) and
 hypocalcemia (due to accicental parathyroidectomy or damage to the parathyroid gland-PG-
 vasculature). Use of intraoperative nerve monitoring (IONM) has reduced the rate of VCP.
 However, the incidence of postoperative hypocalcemia is still high (15-70%), and it is now
 the most common complication of TT. Intraoperative identification of SLNs and PGs can help
 surgeon to overcome these problems.
Inclusion Criteria:

 -  Thyroid carcinoma patients (biopsy/cytology-proven) suitable for total thyroidectomy
 procedure

 -  Patients at or over 17 years

 Exclusion Criteria:

 -  Previous thyroid surgery

 -  Patients below 17 years