Application of preoperative ultrasound-guided injection of nano-carbon for central lymph node dissection in papillary thyroid carcinoma

Abstract

Objective: To explore a better tracing of central lymph nodes in papillary thyroid carcinoma patients by comparing the differences in number and staining of central lymph nodes and in nano-carbon extravasation between preoperative ultrasound- guided injection and intraoperative injection of nano-carbon. Methods: Totally 302 patients were randomly divided into a preoperative ultrasound- guided injection group and an intraoperative injection group. The number and staining of lymph nodes in each sub-area of the central region were recorded and analyzed, including linea alba cervical lymph nodes, Delphian lymph nodes, and pretracheal and paratracheal lymph nodes. Results: Nano-carbon is prone to infiltration to the extraglandular area when injected intraoperatively. Significantly more linea alba cervical lymph nodes and pretracheal and paratracheal lymph nodes were detected in the preoperative injection group. Preoperative injection of nano-carbon can accelerate the staining and detection of central lymph nodes in patients complicated with Hashimoto's thyroiditis, with clinically lymph node positivity (cN1) assessed before surgery, or with tumor diameter >1 cm. Conclusion: Preoperative ultrasound-guided injection of nano-carbon can reduce dye spillover and improve the staining rate and detection rate of central lymph nodes.