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Wuguo Tian, Yan Jiang, Bo Gao, Xiaohua Zhang, Shu Zhang, Jianjie Zhao, Yujun He, Donglin Luo
(Department of General Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China (mainland))
Med Sci Monit 2014; 20:1925-1930
The aim of this study was to explore a new method to identify and protect parathyroid glands in neck lymph node dissection for patients with thyroid cancer.
Material and Methods: One hundred patients with thyroid cancer underwent total thyroidectomy combined with central neck lymph node dissection. During the operation, 50 patients receiving nano-carbon suspension were included in the experiment group, and 50 patients without nano-carbon suspension were included in the control group. We compared changes in parathyroid hormone levels before surgery and at 48 h after surgery between the 2 groups and of serum Ca^2+ level within 48 h after surgery, as well as postoperative parathyroid pathological and lymph node dissection results.
Results: Eight and 1 parathyroid glands were detected pathologically in the control and experimental group, respectively. Decrease in parathyroid hormone level at 48 h occurred in 7 patients in the control group and 1 patient in the experimental group. Hypocalcemia was found at 48 h after surgery in 10 patients in the control group and 2 patients in the experimental group.
Conclusions: Nano-carbon suspension can cause development of the thyroid gland and the central lymph node and a negative development of parathyroid glands. Careful identification and removal of black-stained lymphatic tissues in the process of total thyroidectomy with neck lymph node dissection can ensure a complete lymph node dissection and prevent parathyroid damage, thus effectively reducing the incidence of hypoparathyroidism.