Application of carbon nanoparticles combined with refined extracapsular anatomy in endoscopic thyroidectomy

Zheng Wang; Hongguang Bo; Yufa Xu; Zilin Bi; Zhaocai Yin; Changsheng Yu; Enxi Luo; Xiaomeng Shi; Bin Chen; Yabing Wang; Rui Sha

doi:10.3389/fendo.2023.1131947

Application of carbon nanoparticles combined with refined extracapsular anatomy in endoscopic thyroidectomy

Front Endocrinol (Lausanne). 2023 Jun 2:14:1131947. doi: 10.3389/fendo.2023.1131947. eCollection 2023.

Authors

Zheng Wang¹, Hongguang Bo¹, Yufa Xu¹, Zilin Bi¹, Zhaocai Yin¹, Changsheng Yu¹, Enxi Luo¹, Xiaomeng Shi¹, Bin Chen¹, Yabing Wang¹, Rui Sha¹

Affiliation

¹ Department of Thyroid and Breast Surgery, Yijishan Hospital, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.

Abstract

Objective: To evaluate the value of refined extracapsular anatomy combined with carbon nanoparticle suspension tracing technology for protecting parathyroid function and the thoroughness of lymph node dissection in the central region during endoscopic thyroid cancer surgery.

Patients and methods: Retrospective clinical data analysis was performed on 108 patients who underwent endoscopic thyroid cancer surgery at the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) from November 2019 to November 2022. Before surgery, thyroid function tests, color Doppler ultrasounds and neck-enhanced CT scans were performed on all patients. Cytopathological diagnosis obtained via ultrasound-guided fine-needle aspiration served as confirmation for the primary diagnosis. It was determined whether to perform a total thyroidectomy or a hemithyroidectomy (HT) together with preventive unilateral (ipsilateral) central neck dissection. Follow-up times were 1 to 34 months.

Results: Transient neuromuscular symptoms were present in 3.70% (4/108) cases, with no permanent neuromuscular symptoms or permanent hypoparathyroidism. Regarding transient hypoparathyroidism, the patients recovered after three months and did not need long-term calcium supplementation. The number of harvested LNs (mean± SD) was 5.54 ± 3.84, with ≤5 in 57.41% (62/108) and >5 in 42.59% (46/108) cases. The number of patients with metastatic LNs was 37.96% (41/108), with ≤2 in 65.85% (27/41) and >2 in 34.15% (14/41) cases.

Conclusions: Fine extracapsular anatomy combined with carbon nanoparticle suspension tracing is effective in endoscopic thyroid cancer surgery. It can improve the thoroughness of prophylactic central neck dissection and recognition of the parathyroid gland and avoid parathyroid injury and other complications to effectively protect parathyroid function.

Keywords: carbon nanoparticles; endoscopic thyroid cancer surgery; extracapsular anatomy; hypoparathyroidism; prophylactic central neck dissection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carbon
Humans
Hypoparathyroidism* / etiology
Nanoparticles*
Retrospective Studies
Thyroid Neoplasms* / pathology
Thyroidectomy / adverse effects

Substances

Carbon

Grants and funding

This work was supported by the Major scientific research project of Anhui Provincial Department of Education [grant number AH040176]. Teaching Quality and Teaching Reform Project of Wannan Medical College [grant number 2022jyxm60]. Science and Technology Achievement Transformation Project of Wuhu Science and Technology Bureau [grant numbers 2021cg35, 2021cg15]. Key scientific research fund project of Wannan Medical College [grant number WK2022ZF17]. Research Foundation for Talents of Yijishan Hospital of Wannan Medical College [grant numbers YR202205, YR20220201]. Foundation for High-level Talents of Provincial Public Medical and Health Institutions (Grant numbers GCCRC2022013, GCCRC2022018).