Evaluation of the clinical value of carbon nanoparticles in endoscopic thyroidectomy and prophylactic central neck dissection through total mammary areolas approach for thyroid cancer

Jie He,Zeyu Zhang,Chaojie Zhang,Fada Xia

doi:10.1186/s12957-021-02427-8

Abstract

BackgroundCarbon nanoparticles (CNs) are tracers used in thyroid surgery of patients with thyroid cancer (TC) to help remove lymph nodes and protect the parathyroid gland. The facilitative effect of carbon nanoparticles in endoscopic thyroidectomy and prophylactic central neck dissection (pCND) has not been reported.MethodsThe protective effect on parathyroid gland (PG) function and the numbers of identified parathyroid glands and central lymph nodes in endoscopic thyroid surgery through the total mammary areolas approach were compared between the CN and control groups.ResultsAll endoscopic thyroidectomies were successfully completed. No difference was found in either group regarding the general characteristics or operative complications. The mean number of superior PGs and inferior PGs identified in situ or in the dissected central lymph tissues was not different between the groups. The mean number of lymph nodes removed by unilateral CND was greater in the CN group than in the control group. However, there was no difference in the number of harvested lymph nodes when excluding the LNs less than 5 mm, which exhibit an extremely low metastatic rate.ConclusionCarbon nanoparticles do not improve the protective effect on the parathyroid gland, especially the inferior glands, in endoscopic thyroid surgery through the total mammary areolas approach. There is no need to use CNs to facilitate the lymph node harvest in endoscopic prophylactic unilateral CND.

Highlights

Thyroid cancer (TC) is the fifth most common cancer in women [1, 2]
Certain studies have confirmed the effectiveness of prophylactic central neck dissection (pCND) in preventing tumor recurrence; on the other hand, other studies reported the opposite with an increased incidence of complications [11, 12]
The facilitative effect of carbon nanoparticles in protecting the parathyroid glands, especially the inferior glands, and in harvesting the central lymph nodes has not been reported for endoscopic thyroidectomy with pCND

Summary

Introduction

Thyroid cancer (TC) is the fifth most common cancer in women [1, 2]. Among all of the types of TC, differentiated thyroid cancer is the most common and surgery isHe et al World J Surg Onc (2021) 19:320 robotic procedures have been gradually accepted for thyroidectomy [3]. Indocyanine green and carbon nanoparticles (CNs) are tracers in current use to help remove central lymph nodes (CLNs) and protect the parathyroid glands (PGs) [6]. The facilitative effect of carbon nanoparticles in protecting the parathyroid glands, especially the inferior glands, and in harvesting the central lymph nodes has not been reported for endoscopic thyroidectomy with pCND. We conducted this study to investigate the value of CNs in protecting parathyroid gland function, identifying the intraoperative parathyroid glands, and harvesting the central lymph nodes during endoscopic thyroid surgery. Carbon nanoparticles (CNs) are tracers used in thyroid surgery of patients with thyroid cancer (TC) to help remove lymph nodes and protect the parathyroid gland. The facilitative effect of carbon nanoparticles in endoscopic thyroidectomy and prophylactic central neck dissection (pCND) has not been reported

Methods

Results

Conclusion