Investigation of the use of special camera technology during thyroid surgery to avoid the need for calcium supplementation after surgery

ISRCTN ISRCTN17501072
DOI https://doi.org/10.1186/ISRCTN17501072
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Protocol serial number 35/26-04-2021
Sponsor Henry Dunant Hospital
Funder Henry Dunant Hospital Center
Submission date
12/06/2021
Registration date
24/06/2021
Last edited
30/12/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Autofluorescence is the natural emission of light by biological structures. The use of autofluorescence in endocrine surgery is a new, innovative and promising technique that can help the surgeon identify and protect the parathyroid glands during surgery, reducing the likelihood of the need for daily calcium and vitamin D supplements after surgery.
The use of this technology is increasing internationally. Although its safety has been confirmed, there is still not much data on its effectiveness. The aim of this study is to show whether the use of the autofluorescence method reduces the risk of temporary or permanent hypocalcemia (low blood calcium), one of the most serious complications after thyroid surgery.

Who can participate?
Patients aged over 18 years who are scheduled to undergo total thyroidectomy (removal of the thyroid gland), with or without neck lymph node dissection

What does the study involve?
Participants will be randomly allocated to receive thyroid surgery with or without the use of the autofluorescence camera. For the study's validity, the selection of patients must be random and automated by a special algorithm, which means that nor the patient or the doctor will choose if the autofluorescence camera will be used.

What are the possible benefits and risks of participating?
The results of this study will help surgeons internationally to make better use of this new technology. This technique is entirely safe for the patient since it does not require any additional intervention on the patient (surgical or pharmaceutical), the patient does not receive ionizing radiation, it does not endanger their health in any way, and it does not increase surgery time.

Where is the study run from?
Henry Dunant Hospital Center (Greece)

When is the study starting and how long is it expected to run for?
April 2021 to April 2023

Who is funding the study?
Henry Dunant Hospital Center (Greece)

Who is the main contact?
Dr Kyriakos Vamvakidis
info@drvamvakidis.gr

Contact information

Dr Kyriakos Vamvakidis
Scientific

59 Skoufa Street
Athens
106 72
Greece

ORCiD logoORCID ID 0000-0002-1663-4839
Phone +30 (0)6944254801
Email info@drvamvakidis.gr

Study information

Primary study designInterventional
Study designSingle-centre interventional prospective randomized study
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleProspective randomized clinical trial for the evaluation of the use of autoFLUorescence technology in the prevention of postoperative hypoPARathyroidism in patients undergoing thyroidectomy with or without neck dissection
Study acronymPARFLU
Study objectivesThe use of autofluorescence may assist the surgeon to earlier identify the parathyroid glands during thyroid operations, and as a result, this may reduce the possibility of postoperative temporary or permanent hypoparathyroidism.
Ethics approval(s)Approved 09/06/2021, Board of Ethics of Henry Dunant Hospital Center (107 Mesogeion Ave P.C. 115 26, Athens, Greece; +30 (0)2106979090; g.papazoglou@dunant.gr), ref: none provided
Health condition(s) or problem(s) studiedPrevention of postoperative hypoparathyroidism in patients undergoing thyroid operations
InterventionThis study will include patients undergoing total thyroidectomy, with or without neck lymph node dissection.

In the first arm, the autofluorescence technique will be used for the intraoperative detection of parathyroid glands.
In the second arm, patients will have a conventional operation.

The allocation of the patients will be random with the use of computer software, neither the patient nor the surgeon will have a choice.

Postoperatively, all patients will have the required blood tests and clinical examination, required to identify those who may develop hyperparathyroidism. The final follow up will take place 6 months after the operation to conclude if the possible postoperative hyperparathyroidism is temporary or permanent.
Intervention typeDevice
PhasePhase III/IV
Drug / device / biological / vaccine name(s)Autofluorescence system - Viron X Maxer Endoscopy
Primary outcome measure(s)

1. Total calcium levels measured using a blood test (colorimetric method) at baseline, 1 day, 1 week, and 6 months
2. Albumin measured using a blood test (colorimetric method) at baseline, 1 day, 1 week, and 6 months
3. Phosphorous measured using a blood test (colorimetric method) at baseline, 1 day, 1 week, and 6 months
4. Intact parathormone levels measured using a blood test (chemiluminescence immunoassay) at baseline, 1 day, 1 week, and 6 months
5. 25-OH-Vit D measured using a blood test (chemiluminescence immunoassay) at baseline

Key secondary outcome measure(s)

1. Number of parathyroid glands detected intraoperatively measured using autofluorescence or direct visualisation during the operation
2. Number of unintentional removals of parathyroid glands measured using the histopathology report at 1 month (after receiving the official report)
3. Number of autotransplantation of parathyroid glands measured using operation notes at day 1

Completion date20/04/2023

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexAll
Target sample size at registration400
Key inclusion criteriaPatients over 18 years old undergoing total thyroidectomy with or without neck lymph node dissection
Key exclusion criteria1. Patients undergoing reoperation for thyroid pathology
2. Patients undergoing less than total thyroidectomy (lobectomy, hemithyroidectomy, subtotal thyroidectomy)
3. Patients who have hyperthyroidism
4. Patients who simultaneously with thyroidectomy have an operation for primary, secondary or tertiary hyperparathyroidism
Date of first enrolment28/06/2021
Date of final enrolment30/09/2022

Locations

Countries of recruitment

  • Greece

Study participating centre

Henry Dunant Hospital Center
107 Mesogeion Avenue
Athens
115 26
Greece

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
IPD sharing planThe datasets generated and/or analysed during the current study will be included in the subsequent results publication.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes
Protocol (other) 30/12/2021 30/12/2021 No No
Study website Study website 11/11/2025 11/11/2025 No Yes

Editorial Notes

30/12/2021: A protocol link has been added to the trial outputs.
22/06/2021: Trial's existence confirmed by the Board of Ethics of Henry Dunant Hospital Center.