FIELD: thyroid surgery.
SUBSTANCE: as a first step during thyroidectomy surgery, indocyanine green angiography (ICGA) is performed after visualizing the thyroid gland and mobilizing its lobes. In this case, 5 mg of indocyanine green (ICG) in a solution of 2.5 mg/ml is administered intravenously and the uptake of ICG in the parathyroid and thyroid glands is observed. The thyroid gland is removed. At the second stage, the perfusion of the parathyroid glands in the surgical wound is assessed by fluorescence color in the near-infrared range. In this case, the fluorescence color 0 (black) indicates devascularization, in this case, reimplantation of the parathyroid glands is performed, 1 (gray/heterogeneous) indicates moderately good vascularization, there is no intrathyroidal localization, reimplantation is not performed, 2 (white) indicates good vascularization, absent intrathyroidal localization, reimplantation is not performed.
EFFECT: method makes it possible to prevent hypoparathyroidism during operations on the thyroid gland, to prevent complications such as fatigue, muscle cramps, bone pain, heart rhythm disturbances, and kidney calcification.
1 cl, 3 dwg, 1 ex
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