Ma Jun-Jie, Zhang Dong-Bao, Zhang Wei-Feng, Wang Xiong
Department of Surgery, Linhai Hospital of Traditional Chinese Medicine, Taizhou, P.R. China.
J Laparoendosc Adv Surg Tech A. 2020 May;30(5):547-552. doi: 10.1089/lap.2019.0794. Epub 2020 Feb 11.
This study aimed to investigate the application of nanocarbon in surgical endoscopy in patients with thyroid cancer for the clinical tracing of level VI sentinel lymph nodes (SLNs) and for parathyroid gland protection. Ninety-three patients with papillary thyroid carcinoma (PTC) who underwent an endoscopic thyroid cancer operation were included. We randomly divided these patients into a control group ( = 42) and a nanocarbon group ( = 51). For the nanocarbon group, after thyroid exposure, nanocarbon was injected into the thyroid gland, and the SLNs were resected and subjected to frozen sectioning and routine pathological examination. In addition, the postoperative calcium and parathyroid hormone (PTH) levels of both groups were analyzed to compare the features of the nanocarbon application. The number of central lymph (level VI) nodes dissected and the number of metastatic lymph nodes identified were analyzed in both groups. The number of dissected lymph nodes from both unilateral and bilateral thyroid surgeries was significantly larger in the nanocarbon group than in the control group. At the same time, the number of identified metastasis lymph nodes dissected were higher in the nanocarbon group than in the control group. We assessed the postoperative calcium and PTH level to evaluate the parathyroid function. Our results show that the nanocarbon group had a better protective effect on parathyroid function than the control group. As a lymph node trace agent, nanocarbon could better evaluate and permit a more clear lymph dissection for patients with PTC. Nanocarbon contributes to a decrease in the incidence rate of parathyroid damage, which has great clinical value.
本研究旨在探讨纳米碳在甲状腺癌患者手术内镜检查中对Ⅵ区前哨淋巴结（SLN）的临床示踪及甲状旁腺保护的应用。纳入93例行内镜下甲状腺癌手术的乳头状甲状腺癌（PTC）患者。我们将这些患者随机分为对照组（n = 42）和纳米碳组（n = 51）。对于纳米碳组，暴露甲状腺后，将纳米碳注入甲状腺，切除SLN并进行冰冻切片和常规病理检查。此外，分析两组患者术后的血钙和甲状旁腺激素（PTH）水平，以比较纳米碳应用的特点。分析两组清扫的中央区淋巴结（Ⅵ区）数量及检出的转移淋巴结数量。纳米碳组单侧和双侧甲状腺手术清扫的淋巴结数量均显著多于对照组。同时，纳米碳组检出的转移淋巴结数量高于对照组。我们评估术后血钙和PTH水平以评价甲状旁腺功能。结果显示，纳米碳组对甲状旁腺功能的保护作用优于对照组。作为一种淋巴结示踪剂，纳米碳能更好地评估PTC患者并使其进行更清晰的淋巴结清扫。纳米碳有助于降低甲状旁腺损伤的发生率，具有重要的临床价值。
