Original Title: Kamerabaserad autofluorescens vid tyreoideakirurgi

Authors' objectives: To assess whether the use of camera-based autofluorescence can reduce the risk of postoperative hypoparathyroidism, with permanent hypoparathyroidism as the primary outcome, in adult patients undergoing total thyroidectomy.

Authors' recommendations: Eight randomized controlled trials including 1,810 patients contributed with data to the primary outcome, permanent hypoparathyroidism. Results show that camerabased autofluorescence may 1 reduce the risk of permanent hypoparathyroidism (18 fewer cases/1000 patients [95 % CI 7/1000–23/1000]). It probably also reduces the risk of early postoperative hypocalcaemia (123 fewer cases/1000 patients [95 % CI 66/1000–170/1000]), and inadvertent parathyroid gland excision (105 fewer cases/1000 patients [95 % CI 82/1000–122/1000]). The absolute effect size for permanent hypoparathyroidism was small but may still be of clinical relevance. Data on duration of surgery were limited and heterogeneous, precluding meta-analysis, and the certainty of evidence regarding this outcome was very low. Most studies were conducted in high-volume centres, which may limit generalizability to broader clinical settings. Health economic evidence on autofluorescence in thyroid surgery is limited, but permanent hypoparathyroidism is associated with increased healthcare costs. A scenario-based economic analysis suggests that, although camera-based autofluorescence may increase short-term costs, these may be offset over time through a lower incidence of permanent hypoparathyroidism.

Authors' methods: This health technology assessment (HTA) included randomized controlled trials comparing camera-based autofluorescence with standard surgical care based on visual identification of the parathyroid glands. Meta-analyses were performed where appropriate, and the certainty of evidence was assessed using the GRADE framework.

Project Status: Completed

Year Published: 2026

URL for published report: https://vardgivare.skane.se/siteassets/3.-kompetens-och-utveckling/sakkunniggrupper/hta/rapporter/2026/kamerabaserad-autofluorescens-vid-tyreoideakirurgi.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Sweden

Organisation Name: HTA South

Contact Address: Skåne University Hospital, Lund

Contact Name: hta.syd@skane.se

Contact Email: hta.syd@skane.se