[Efficiency of carbon nanoparticles in level VI lymphadenectomy for thyroid carcinoma and prevention of postoperative hypoparathyroidism].

Abstract

OBJECTIVE:

To assess the efficiency of carbon nanoparticle in guiding level VI lymphadenectomy and parathyroid preservation in thyroidectomy for carcinoma.

METHODS:

One hundred and nine patients with well differentiated thyroid carcinoma, in whom thyroidectomy and bilateral lymphadenectomy for level VI were carried out at the same time, were prospectively studied. Fourty-five cases received carbon nanoparticle injecion in thyroid consistitued trial group, while sixty-four underwent conventional surgery as control group. The numbers of total dissected lymph nodes, metastasis lymph nodes, black-stained lymph nodes, detected parathyroids and mistakenly removed parathyroids were counted respectively. The PTH levels were measured at 1 d, 5 d and 30 d after surgery, respectively. Student's t test and Chi-square analysis were used for analyzing data.

RESULTS:

The number of lymph node found in the trial group in level VI was checked out as (9.7 ± 1.7) each side, whereas that of the control group was (6.7 ± 1.9) each side. The discrepancy of two groups was statistical meaningful (t = 23.14, P < 0.001). The discrepancy of the rate of lymph node black-stained 90.5% (738/815), incidence of metastasis of the black-stained lymph nodes 45.9% (339/738) and that without black-staining 13.0% (10/77), was statistical meaningful (χ(2) = 30.91, P < 0.001). On average, the trial group showed (1.8 ± 0.9) parathyroid each side, and had 5.9% (5/84) of mistakenly removed incidence , on contrary, the control group showed (1.8 ± 1.0) parathyroid each side, and had 8.2% (11/134) of mistakenly removed incidence averagely as well. The discrepancy of two groups was statistical meaningful. In the trial group, the amount of PTH 1 d, 5 d and 30 d postoperatively were 7.30, 11.19 and 30.50 ng/L respectively, while that of the control group were 7.51, 10.90 and 28.30 ng/L respectively. The amount discrepancy between the two groups was not differences. No permanent recurrent nerve paralysis was found in both groups.

CONCLUSION:

Carbon nanoparticle may improve the detected rate of metastasis lymph nodes, but may not be helpful to the prevention of postoperative hypoparathyrosim.

• Authors: Hong Shen, Bojun Wei, Shui Feng, Quan Zhou
• Journal: Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery (Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi) Vol. 49 Issue 10 Pg. 817-20 (Oct 2014) ISSN: 1673-0860 [Print] China
• PMID: 25567436 (Publication Type: Journal Article)

Chemical References

• Nanotubes, Carbon
• Carbon

Topics

• Carbon
• Carcinoma
• Humans
• Hypoparathyroidism (prevention & control)
• Lymph Node Excision
• Lymph Nodes
• Lymphatic Metastasis
• Nanoparticles
• Nanotubes, Carbon
• Parathyroid Glands
• Postoperative Period
• Staining and Labeling
• Thyroid Neoplasms (therapy)
• Thyroidectomy (methods)