Abstract

Objective To explore the significance of carbon nanoparticles in routine central lymph node dissection of papillary thyroid microcarcinoma (PTMC) . Methods 272 cases of PTMC admitted from 2013 to 2015 were retrospectively analyzed and they were divided into two groups, the experimental group who were given carbon nanoparticles during surgery (136 cases) and the control group (136 cases) without carbon nanoparticles. The total number of central lymph nodes, number of transfer, and the black dye lymph node number and transfer number in the experimental group were recorded. The total number of lymph nodes, and number of transfer in the control group were recorded. The metastasis rate of the two groups were analyzed. The number of parathyroid mistakenly cut and hypocalcemia cases of the two groups were counted. Parathyroid function was observed by determination of Ca2+ and PTH in blood. The incidence of recurrent laryngeal nerve (RLN) injury of the two groups was compared. Results The total number of central lymph nodes was 1216 and the transfer number was 481 in the experimental group, higher than those of the control group. The positive lymph node rate of the two groups was 39.6% and 25.9% respectively, and the difference was statistically significant. The mumber of patients with central lymph node metastasis was 63 and 42 respectively for the experimental group and the control group, and the transfer rate was 46.3% and 30.8% respectively. The difference was statistically significant. The rate of parathyroid mistakenly cut was 2.6% (7/261) and 14.7% (28/193) respectively for the experimental group and the control group, and the difference was statistically significant. The difference of Ca2+ and PTH value at 3h, 6h, and 12h after surgery between the two group was statistically significant. No RLN injury occured. 5 cases in the experimental and 8 cases in the control group had temporary RLN injury. The difference was not statistically significant. Conclusions The application of carbon nanoparticles in PTMC surgery can help to improve the thoroughness of central lymph node dissection and to protect parathyroid function. However, its benefits to protect the recurrent laryngeal is uncertain. Key words: Carbon nanoparticles; Papillary thyroid microcarcinoma; Central lymph node dissection; Parathyroid; Recurrent laryngeal nerve

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