Qian Y C, Liu F Z, Yao W P, Zhao Y B, Jiang Y, Zhang Y
Department of Head and Neck Surgery, the Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Jan 7;54(1):28-32. doi: 10.3760/cma.j.issn.1673-0860.2019.01.007.
To evaluate the effects of staining with carbon nanoparticles on the identification of parathyroid glands and lymph nodes during thyroid carcinoma surgery combined with lymphadenectomy. A total of 194 patients with papillary thyroid carcinoma who underwent thyroidectomy combined with lymphadenectomy from April 2016 to January 2018 were reviewed. Of them 104 cases were injected with carbon nanoparticles in operation area (nanocarbon group) and other 90 cases without the injection of carbon nanoparticles were as control group. The incidence of mistakenly dissection of parathyroid glands and the levels of serum calcium and parathyroid hormone in 1 day, 3 days, 1 month and 6 months after surgery were compared between two groups of patients. Chisquare and ranksum test were used to analyze 2 data. There were no significant differences in age, gender, tumor size, operation time, extrathyroidal invasion and multifocality between two groups. Compared with control groups, nanocarbon group showed a significantly lower incidence of mistakenly dissection of parathyroid glands (8 cases 2 cases, 8.9% 1.9%,χ(2)=4.9, =0.026) and a significantly lower incidence of hypoparathyroidism (41 cases 28 cases, 45.5% 26.9%, χ(2)=7.3, =0.007). The number of lymph nodes dissected from central compartment was 791 in nanocarbon group and 536 in control groups, with a statistically significant difference (=-2.2, =0.028). There was a significant difference in the number of lymph nodes removed from the right neck Ⅵb level between nanocarbon group and control group (41 nodes 93 nodes, =-2.1, =0.034). Treatment with nanocarbon can significantly facilitate the identification of the parathyroid during total thyroidectomy combined with central compartment lymphadenectomy, reduce the incidence of postoperative hypoparathyroidism, and improve the dissection of lymph node in the central compartment.
评估碳纳米颗粒染色对甲状腺癌手术联合淋巴结清扫术中甲状旁腺和淋巴结识别的影响。回顾性分析2016年4月至2018年1月期间194例行甲状腺切除术联合淋巴结清扫术的乳头状甲状腺癌患者。其中104例在手术区域注射碳纳米颗粒（纳米碳组），另外90例未注射碳纳米颗粒作为对照组。比较两组患者甲状旁腺误切发生率以及术后1天、3天、1个月和6个月时血清钙和甲状旁腺激素水平。采用卡方检验和秩和检验分析数据。两组患者在年龄、性别、肿瘤大小、手术时间、甲状腺外侵犯和多灶性方面无显著差异。与对照组相比，纳米碳组甲状旁腺误切发生率显著降低（8例对2例，8.9%对1.9%，χ²=4.9，P=0.026），甲状旁腺功能减退发生率也显著降低（41例对28例，45.5%对26.9%，χ²=7.3，P=0.007）。纳米碳组中央区清扫淋巴结数为791枚，对照组为536枚，差异有统计学意义（Z=-2.2，P=0.028）。纳米碳组与对照组在右颈部Ⅵb区清扫淋巴结数方面存在显著差异（41枚对93枚，Z=-2.1，P=0.034）。碳纳米颗粒处理可显著有助于全甲状腺切除联合中央区淋巴结清扫术中甲状旁腺的识别，降低术后甲状旁腺功能减退的发生率，并改善中央区淋巴结的清扫。
