Clinical application of carbon nanoparticles in patients with thyroid carcinoma undergoing total thyroidectomy plus bilateral central neck dissection

Abstract

Objective To evaluate the role of cabon nanoparticles for dissecting lymph nodes and preserving parathyroid glans in patients with differentiated thyroid carcinoma undergoing total thyroidectomy plus bilateral central neck dissection. Metheds From Sep. 2015 to Feb. 2016, 100 patients in Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine with thyroid carcinoma undergoing primarily total thyroidectomy plus bilateral central neck dissection were randomly divided into carbon nonoparticle group and the contol group. The numbers of total dissected lymph nodes, the lymph node posterior to fight recurrent laryngeal nerve, metastasized lymph nodes, inadvertent parathyroidectomy, the parathyroid hormone and serum total calcium were measured. Results The average counts of lymph nodes in carbon nonoparticle group (10.96±5.43) were more than those in the control group at (8.22±4.40) lymph nodes, (t=2.78, P=0.01) . The average counts of lymph node posterior to fight recurrent laryngeal nerve in carbon nonoparticle group (1.62±1.95) were more than those in the control group at (0.76±1.21) lymph nodes, (t=2.66, P=0.01) . The numbers of metastasized lymph nodes was 2.02±2.40 in carbon nonoparticle group and 1.84±2.61 in the control group. The difference had no statistical significance (t=0.36, P>0.05) . The amount of PTH and the decrease of PTH discrepancy one day after surgery between the two groups had no statistical difference (t=0.23, P>0.05) , (t=1.04, P>0.05) . The carbon nonoparticle group had 2% (1/50) mistakenly parathyroid gland removed incidence, on contrary, the control group had 6% (3/50) mistakenly removed incidence. The difference had no statistical significance (χ2=0.26, P>0.05) . Conclusion Carbon nonoparticle can improve the central lymph node detection rate, but the protection of the parathyroid glands is more likey to depend on the experience of the operator and the vascular protection. Key words: Thyroid neoplasms; Thyroidectomy; Parathyroid hormone; Carbon