The advantages of carbon nanoparticles in level VII lymph node dissection in patients with papillary thyroid cancer

Abstract

Background: The characteristics of level VII lymph nodes were explored and the advantages of using carbon nanoparticles (CNs) in papillary thyroid cancer (PTC) surgeries were examined. This was a retrospective study investigating the clinical data of patients with PTC who underwent surgical treatment. Methods: From September 2019 to December 2020, a total of 191 consecutive patients with PTC were retrospectively analyzed. The patients were randomly divided into the CNs group and the control group. CNs were used in the CNs group during the operation. There were 103 cases in the CNs group, including 25 males and 78 females, and 88 cases in the control group, including 21 males and 67 females. Parameters, including the characteristics of dissected lymph nodes in level VII, metastatic rate, postoperative complications, and other inpatient-related indicators, were compared between the two groups.Results: The number of lymph nodes dissected in level VII in the CNs group was significantly greater than that in the control group, and the metastatic rate of black-stained lymph nodes was significantly higher than that of non-black-stained lymph nodes (P<0.05). The postoperative hypoparathyroidism rate in the CNs group was significantly lower than that in the control group (P<0.05). There were no differences in the operation duration, intraoperative blood loss, postoperative drainage duration, or hospitalization days between the two groups (P>0.05). Conclusions:The application of CNs for patients with PTC significantly increased the number of lymph nodes dissected in level VII and helped to protect the parathyroid glands (PGs). Moreover, the use of CNs did not increase the rate of postoperative complications. Thus, CNs may be a simple and safe approach when performing surgery in PTC patients.

The Role of Carbon Nanoparticles in Lymph Node Dissection and Parathyroid Gland Preservation during Surgery for Thyroid Cancer: A Systematic Review and Meta-Analysis

“…After full-text analysis was performed, 41 studies were excluded, as the design, protocol and/or methodology used investigated a different PICO question to those of our study. Ultimately, 20 studies [ 19 , 20 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ] were included in the qualitative and quantitative synthesis. The flowchart of the studies selection process is shown in Figure 1 .…”

“…The publication date of the studies that were included in this systematic review and meta-analysis ranged from 2012 to 2021 with four studies published in 2021 [ 20 , 24 , 25 , 26 ]. The shortest study period among the studies was eleven months [ 35 ], while the longest one was sixty months [ 29 ]. The total number of patients across the 20 studies included in this systematic review and meta-analysis was 2920.…”

Predictors of impaired effectiveness of carbon nanoparticle-based central lymph node tracing in patients who underwent surgery for papillary thyroid cancer: A retrospective cohort study

“…Some studies have shown that the application of CNs in PTC surgery increases the detection rate of lymph nodes and reduces the injury of PGs in both conventional and endoscopic PTC surgeries. [ 10 – 12 , 16 , 22 , 23 ]…”

“…Some studies have shown that the application of CNs in PTC surgery increases the detection rate of lymph nodes and reduces the injury of PGs in both conventional and endoscopic PTC surgeries. [10][11][12]16,22,23] However, the effect of using CNs in some patients with PTC who underwent CLND does not necessarily meet expectations, even in experienced hands. HT is associated with a significantly higher risk of PTC and is an autoimmune disease caused by an overproduction of antithyroid antibodies that destroy thyroid tissue.…”

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

“…CNs can only enter lymphatic vessels, where they are swallowed by macrophages and transported to the draining lymph node. The thyroid gland and draining lymph nodes are stained black, leaving the parathyroid glands unstained, enabling easy identification of parathyroid glands from surrounding tissues during conventional open thyroid surgeries [ 7 , 8 ]. However, a consensus about CN usage has not yet been established regarding its improvement in the extent of neck dissection and the preservation of the parathyroid glands after TC surgery with endoscopic approaches [ 9 , 10 ].…”