Intraoperative near-infrared autofluorescence imaging for hypocalcemia risk reduction after total thyroidectomy: Evidence from a meta-analysis

Head Neck. 2021 Aug;43(8):2523-2533. doi: 10.1002/hed.26733. Epub 2021 May 5.

Abstract

This meta-analysis evaluates whether near-infrared autofluorescence (NIRAF) imaging reduces the risk of hypocalcemia after total thyroidectomy. A systematic literature search in PubMed, EMBASE, Web of Science, and Cochrane Library for studies from June 2011 to January 2021 comparing total thyroidectomy with NIRAF and conventional surgery (naked eye). Six eligible studies involving 2180 patients were included. The prevalence of transient hypocalcemia was 8.11% (40/493) and 25.19% (425/1687) in the NIRAF and naked eye groups (p < 0.0001), respectively. The prevalence of permanent hypocalcemia was 0% (0/493) and 2.19% (37/1687) in the NIRAF and naked eye groups (p = 0.05), respectively. NIRAF reduces the risk of transient hypocalcemia and may possibly lower the rate of permanent hypocalcemia. Nonetheless, further studies are needed to verify our results and evaluate the cost-effectiveness of NIRAF in real-world clinical practice.

Keywords: autofluorescence; hypocalcemia; meta-analysis; near-infrared; thyroid surgery.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Hypocalcemia* / epidemiology
  • Hypocalcemia* / etiology
  • Hypocalcemia* / prevention & control
  • Optical Imaging
  • Parathyroid Glands
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Risk Reduction Behavior
  • Thyroidectomy / adverse effects