Activated carbon nanoparticles or methylene blue as tracer during video‐assisted thoracic surgery for lung cancer can help pathologist find the detected lymph nodes

Abstract

To assess whether using methylene blue (MB) or activated carbon nanoparticles as tracer can increase the detected number of lymph nodes in the systematic nodal dissected tissue during Video-Assisted Thoracic Surgery (VATS) for non-small cell lung cancer. Three groups of 20 patients each were obtained from randomization of 60 patients with NSCLC requiring VATS with systematic nodal dissection (SND) from February 2007 and December 2008, there were 17, 16, and 17 patients in group A (injection activated carbon nanoparticles), group B (injection MB), and group C (controls), respectively. There was difference of the total number of dissected lymph nodes per patient among three groups (P < 0.001). The total number of dissected LNs and mediastinal nodes per patient in group A and group B was more than in group C (P < 0.001). There were 20, 18, and 14 metastatic LNs dissected in 6, 6, and 7 patients of group A, B, and C, respectively. There was difference of total number of dissected metastatic LNs per patient among three groups (P = 0.002). MB can be as effective as activated carbon nanoparticles being tracer to increase the detected number of LNs in the systematic nodal dissected tissue during VATS for NSCLC.