Preoperative injection of carbon nanoparticles is beneficial to the patients with thyroid papillary carcinoma

Abstract

Background:More surgeons had noticed the importance of carbon nanoparticles (CNs) in protection of parathyroid grand in the surgery of thyroidectomy and central lymph lode dissection, but paid less attention to the injection time. The purpose of this study was to investigate whether preoperative injection of CNs can improve the dissection of lymph nodes (LNs) and protect parathyroid grand (PG) for the patients with papillary thyroid carcinoma (TC).Methods:A total of 102 consecutive patients were enrolled into this study from August 2016 to June 2017. All the patients were divided randomly into preoperative group and intraoperative group by the injecting time of the CNs. We compared the patients who had CNs injected into thyroid gland 1 month before surgery with a control group of patients who had CNs injected during the operation. The primary endpoints were operative time, numbers of total LN and metastatic LN, ratio of PG auto-transplantation, parathyroid hormone (PTH) level, and postoperative complications.Results:We identify 206 PGs and 162 PGs in the preoperative and intraoperative group, respectively, (P = .000) and there was low ratio of auto-transplantation in the preoperative group compared with the intraoperative group (39.3% vs 50.62%, P = .003). We also found that the PTH level in the preoperative group was higher than that of preoperative group (2.60 ± 1.00 vs 2.19 ± 0.72, P = .021), and the operation time in the preoperative group was less than the intraoperative group (60.17 ± 6.28 vs 80.94 ± 7.12, P = .000). Meanwhile pathological results revealed 3 PGs of accidental removal occurred in the preoperative group, whereas 9 PGs of accidental removal occurred in the intraoperative group (P = .039). Also there was no difference in the numbers of total and metastatic LN in the 2 groups (P > .05).Conclusion:Preoperative injection of CNs was safe, and can help protect PG and reduce the difficulty of operation.

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

“…However, inappropriate intraoperative injection of CNs can cause extravasation of CNs around the thyroid gland, making the identification of parathyroid glands and recurrent laryngeal nerve (RLN) challenging (18). 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).…”

Nanoparticles can improve the positive rate of metastatic lymph node in thyroid cancer surgery

“…Carbon nanoparticles with an average diameter of 150nm can enter lymphatic vessels (with an average diameter of 500nm) rather than capillaries (with an average diameter of 30-50nm), allowing the development of lymph nodes. Since the lymphatic vessels of thyroid gland and parathyroid gland do not communicate with each other, most scholars believe that negative development of parathyroid gland has a protective effect on it, and it has been widely used in thyroid cancer surgery in recent years 9 .The results of this study showed that there was a signi cant statistical difference between the experimental group and the control group in the total number of lymph nodes cleared and the positive rate of metastatic lymph nodes. Consistent with the views of luo wenzheng and other researchers [10][11][12] 11111111111156456466---][i]222115415,Considering carbon nanoparticles can help surgeons better identify lymph nodes in the central region, especially the microscopic nodes that are di cult to be distinguished by the naked eye, reduce lymph node residues, and make it easier and more accurate for pathologists to extract lymph nodes 13 .Together, the two can increase the number of lymph nodes detected, and the corresponding seizure rate of metastatic lymph nodes is also improved, which is conducive to more accurate postoperative judgment of staging and prognosis, as well as elimination of potential sources of lymph node recurrence [14][15] .However, there was no statistical difference in the changes of blood calcium and PTH between the experimental group and the control group at 3 and 30 days after surgery (P > 0.…”

Prophylactic Bilateral Central Neck Dissection Should Be Evaluated Based on Prospective Study of 581 PTC Patients

“…We had to emphasize the importance of PG transplantation as soon as possible, especially in the patents that the PG was not in situ or misresection [23]. with the help of new ways of nding RLN, PG recognition and auto-transplantation [24][25][26], BCND may be safe in the patients with cN0 PTC in our study based on the long-term results because it may guarantee an adequate surgical resection in patients with occult nodal disease and reduced the risk of tumor recurrence theoretically. So BCND may be a feasible treatment option, but who was suitable for BCND will be a question to be discussed.…”