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评估通过全乳晕入路内镜甲状腺切除术和预防性中央颈部清扫术治疗甲状腺癌中碳纳米颗粒的临床价值。

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

机构信息

Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital (First Affiliated Hospital of Hunan Normal University), Changsha, 410005, Hunan, China.

Department of General Surgery, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, China.

出版信息

World J Surg Oncol. 2021 Nov 4;19(1):320. doi: 10.1186/s12957-021-02427-8.

DOI:10.1186/s12957-021-02427-8
PMID:34736481
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8570033/
Abstract

BACKGROUND

Carbon nanoparticles (CNs) are tracers used in thyroid surgery of patients with thyroid cancer (TC) to help remove lymph nodes and protect the parathyroid gland. The facilitative effect of carbon nanoparticles in endoscopic thyroidectomy and prophylactic central neck dissection (pCND) has not been reported.

METHODS

The protective effect on parathyroid gland (PG) function and the numbers of identified parathyroid glands and central lymph nodes in endoscopic thyroid surgery through the total mammary areolas approach were compared between the CN and control groups.

RESULTS

All endoscopic thyroidectomies were successfully completed. No difference was found in either group regarding the general characteristics or operative complications. The mean number of superior PGs and inferior PGs identified in situ or in the dissected central lymph tissues was not different between the groups. The mean number of lymph nodes removed by unilateral CND was greater in the CN group than in the control group. However, there was no difference in the number of harvested lymph nodes when excluding the LNs less than 5 mm, which exhibit an extremely low metastatic rate.

CONCLUSION

Carbon nanoparticles do not improve the protective effect on the parathyroid gland, especially the inferior glands, in endoscopic thyroid surgery through the total mammary areolas approach. There is no need to use CNs to facilitate the lymph node harvest in endoscopic prophylactic unilateral CND.

摘要

背景

碳纳米粒子(CNs)是甲状腺癌(TC)患者甲状腺手术中使用的示踪剂,有助于清除淋巴结并保护甲状旁腺。碳纳米粒子在内镜甲状腺切除术和预防性中央颈部清扫术(pCND)中的促进作用尚未报道。

方法

通过乳晕入路行内镜甲状腺手术,比较 CN 组和对照组对甲状旁腺(PG)功能、甲状旁腺和中央淋巴结的保护作用。

结果

所有内镜甲状腺切除术均成功完成。两组的一般特征和手术并发症无差异。两组原位或解剖中央淋巴结组织中识别的上、下 PG 平均数量无差异。单侧 CND 切除的淋巴结数量,CN 组多于对照组。然而,排除 5mm 以下的淋巴结(转移率极低)后,两组的淋巴结数量无差异。

结论

碳纳米粒子不能提高经乳晕入路内镜甲状腺手术中对甲状旁腺的保护作用,尤其是下甲状旁腺。在经乳晕入路内镜预防性单侧 CND 中,没有必要使用 CN 来促进淋巴结的清扫。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/3befcd3db4fe/12957_2021_2427_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/24b4867ac06d/12957_2021_2427_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/9589fd037d38/12957_2021_2427_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/84add2195887/12957_2021_2427_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/3befcd3db4fe/12957_2021_2427_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/24b4867ac06d/12957_2021_2427_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/9589fd037d38/12957_2021_2427_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/84add2195887/12957_2021_2427_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/007a/8570033/3befcd3db4fe/12957_2021_2427_Fig4_HTML.jpg

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