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Endocrine Abstracts (2021) 73 PEP6.5 | DOI: 10.1530/endoabs.73.PEP6.5

ECE2021 Presented Eposters Presented ePosters 6: Calcium and Bone (8 abstracts)

The effect of intra-operative autofluorescence monitoring on unintentional parathyroid gland excision rates and post-operative PTH concentrations – a single-blind randomized controlled trial

Theodosios Papavramidis1, 2, Angeliki Chorti1, George Tzikos1, Panagiotis Anagnostis3, Pantelis Pantelidis1, Ioannis Pliakos1, 2, Stavros Panidis1, 2, Maria Papaioannou4, Sohail Bakkar5, Ethem Unal6 & Antonios MIchalopoulos1

11st Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Department of Minimal Invasive Endocrine Surgery, Interbalkan Medical Center, Thessaloniki, Greece; 3Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece; 4Laboratory of Biological Chemistry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; 5Department of Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan; 6Department of General Surgery, Umraniye Education and Research Hospital, Health Sciences University-Medical Faculty, Istanbul, Turkey


Intraoperative imaging of parathyroid glands (PGs) has been developed in order to reduce the risk of unintentional parathyroidectomy during total thyroidectomy. This novel modality is based on their intrinsic characteristic of autofluorescence (AF) after near-infrared light exposure. The aim of this study was to assess the effect of this method on the risk of unintentional PG excision (total or partial) during total thyroidectomy.


This was a single-blind, randomized, controlled trial including adult patients who underwent scheduled total thyroidectomy between December 2019 and March 2020. These patients were randomly allocated to two groups: one in which near-infrared autofluorescence imaging (NIRAF) was applied (NIR-group) and one without NIRAF (NONIR-group). Hormonal and biochemical assessment was performed pre- and 24 h post-operatively. AF findings and the number of PGs autotransplanted were recorded.


One-hundred eighty patients were eligible. Unintentional (total or partial) PG excision rates during total thyroidectomy in the NONIR (n = 90) and NIR (n = 90) groups were 28.9% [95% confidence interval (CI) 19.8%39.4%] and 14.4% (95% CI 7.7%22.1%), respectively (P = 0.02). Furthermore, NIR reduced the risk of parathyroid tissue presence in the specimen sent for pathology (relative risk 0.51, 95% CI 0.280.92; P = 0.02). However, the number of PGs identified by NIR could not predict the risk of post-operative hypoparthyroidism.


NIRAF imaging during total thyroidectomy led to a significant reduction in PG excision rates. However, this modality did not result in the reduction of post-operative hypoparathyroidism or hypocalcemia risk.

Volume 73

European Congress of Endocrinology 2021

22 May 2021 - 26 May 2021

European Society of Endocrinology 

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