Carbon nanoparticles guide contralateral central neck dissection in patients with papillary thyroid cancer

Abstract

The treatment of contralateral central neck lymph node metastasis is controversial in patients with papillary thyroid cancer. The present study reports the use of carbon nanoparticles (CNs) as lymph node tracers and discusses the potential role of predicting contralateral central neck metastasis is evaluated, so as to guide contralateral central neck dissection (CND). A total of 70 consecutive patients with papillary thyroid cancer were enrolled in the present study. All patients underwent a total or near-total thyroidectomy plus bilateral CND, during which CNs were used as a lymph node tracer. Of the 70 enrolled patients, 51 (72.86%) were confirmed to have lymph node metastasis in the central neck, 50 (71.43%) patients in the ipsilateral central neck and 14 (20.00%) in the contralateral central neck. A total of 579 (84.90%) lymph nodes were stained black by CNs. Of the 193 metastatic lymph nodes, 168 were located in the ipsilateral central compartment and the other 25 in the contralateral central compartment. A total of 147 (76.17%) metastatic lymph nodes were stained black. A total of 21 metastatic lymph nodes were found in the contralateral central compartment, 4 metastatic lymph nodes of contralateral central compartment were not black-stained. The sensitivity and specificity of CNs for contralateral metastasis was 84 and 25%, respectively. Contralateral central lymph node metastasis was significantly associated with extrathyroid extension and the presence of ipsilateral central neck lymph node metastasis. Together, the results of the present study reveal that CNs might accurately predict contralateral central lymph nodes metastasis and could be used to direct CND.

Infiltration of nanocarbon suspension into the tracheal cavity during surgical treatment of papillary thyroid carcinoma: a case report

“…4 Although a few articles have mentioned the injection depth, this depth is not the same among different reports; some surgeons inject the suspension into the superficial thyroid gland to a depth of 2 to 3 mm, while others inject the suspension more deeply into the thyroid gland to no definite depth. 15,16 In the present case, two injection points around the tumor were selected, the total injection volume was 0.4 mL, and the waiting time was 10 minutes; these parameters are consistent with those reported in the literature. 4 When the tracheal tube was retrieved after the operation, some carbon-containing secretions were present in the mouth, and the inflatable balloon surface of the tracheal tube was covered with these secretions.…”

Preoperative Visualized Ultrasound Assessment of the Recurrent Laryngeal Nerve in Thyroid Cancer Surgery: Reliability and Risk Features by Imaging

“…During the preoperative ultrasound scanning, five patients in our sample were found to have adenopathy in the central neck adjacent to the RLN. Since carbon nanoparticles are widely used in operations to trace lymph nodes, 14 we selected one lymph node adjacent to the RLN in each of these patients for injection of carbon nanoparticles (Lai Mei Pharmaceutical Co, Chongqing, China). Injection was made in pre-operative room before the operations and the interval time from injection to surgery was less than 24 hours.…”

Preoperative application of carbon nanoparticles in bilateral axillo-breast approach robotic thyroidectomy for papillary thyroid cancer

“…Additionally, the intraoperative injection procedure of CNs prolonged the operative time (18)(19)(20). Moreover, the staining rate of the lymph node was not satisfactory (21)(22)(23)(24). Although preoperative ultrasoundguided CNs injection became a promising feasible approach that seems to have fewer shortcomings and a favorable surgical outcome, only two studies have addressed the preoperative application of CNs (20,25).…”