Zhang Chaojie
Hunan Provincial People’s hospital,China
Title: Evaluation of the clinical value of carbon nanoparticle as lymph node tracer in differentiated thyroid carcinoma required reoperation
Biography
Biography: Zhang Chaojie
Abstract
Background: The incidence of the parathyroid injury in differentiated thyroid carcinoma(DTC) underwent the reoperation was significantly higher than initial surgery. The aimof this study is to investigate the clinical value of carbon nanoparticles (CN) as tracersfor lymph nodes to guide cervical lymph node dissection and protect the parathyroid in the reoperation of DTC.
Methods:The study recruited 116 patients with DTCs who previously underwentthyroidectomy and later received the remedial surgical treatment at the Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital, China, between February 2011 and February 2014.Those patients were randomly divided into the experimental group (the CN group) with 64 cases and the control group with 52 cases.Carbon nanoparticles suspension (CNS) of 0.1 mL to 0.3 mL was intraoperatively injected into the residual thyroid, and/or enlarged lymph nodes in the CN group, and in the control group CNS was not applied intraoperatively. The differences of parathyroid identified, the number of lymph nodes resected intraoperatively as well as the incidence of common complications after thyroidectomy in both groups were recorded and analyzed.
Results: The identification accuracy of the parathyroid in the CN group and control group were 92.2% and 28.8%, respectively, and the identification rate of the three glands or above in both groups were 75% and 36.5%, respectively, those differences were statistically significant between the two groups(P＜0.05). And there was also significant difference between the two groups in the number of the lymph nodes removed in the central and lateral cervical compartments (P＜0.05). There was no increase in the common complications after the second surgery compared with the previous surgery; in addition, there was a decline in the incidence of transient hypoparathyroidism (HPT) (P＜0.05).
Conclusions: By tracing of the thyroid and cervical regional lymph nodes with carbonnanoparticles, parathyroid glands can easily be identified and protected to reducecomplications of transient hypoparathyroidism in the reoperation for residual and/or missed DTC; carbon nanoparticle tracers also facilitate radical resection of lymph nodes at central and lateral compartments of neck.