The Protection Of Parathyroid Glands In Thyroidectomy Using Carbon Nanoparticle Trace Method

【Objective】To introduce the methods and clinical efficacy of Thyroid Lymphography(TLG) using carbon nanoparticle, and its injection points, tracer characteristics,compare the advantages and disadvantages of two tracer; the role of thyroid lymphography in protecting parathyroid glands and detecting lymph node metastasis.【Methods】A total of140patients with clinically papillary thyroid carcinoma were meet selected criteria and enrolled,and136of them underwent thyroidectomy.68of them inject0.1ml carbon nanoparticle,68of them do not inject carbon nanoparticle around the tumors, observe the morphology of thyroid and parathyroid，and the black-stained lymph nodes were collected from the central compartments. Statistics two groups each seizure of number of lymph nodes, and lymph node specimens were divided into dyed and undyed for pathological examination, which to understand each group lymph node metastasis. We also using conventional surgical procedures revealed parathyroid and for lymph node dissection, controlled observe the parathyroid protection and seized lymph nodes.【Results】The injection of carbon nanoparticle led to no major complications such as anaphylaxis, the lymph nodes were stained black by carbon nanoparticle, and parathyroid gland was not dyed, all this remind the surgeons of protecting the parathyroid glands. The pathologic examination revealed8parathyroids were mistakenly cut in the normal group while1parathyroids were mistakenly cut in carbon nanoparticle group. There was no case of patients with permanent hypoparathyroidism. As for carbon nanoparticle group, the average initial tracer time was61.3±13.0minuets, compared to60.7±13.4minuets with the normal group,the difference was not statistically significant. Group of thyroid lymphatic tracer the parathyroid mistakenly cut rate is lower than the normal surgery group. Stained lymph node metastasis was higher than carbon nanoparticle group. 【Conclusions】1)using carbon nanoparticle may remind the surgeons of protecting the parathyroid glands,2) Stained lymph node do not means metastasis, the method of TLG can only use as indicate lymphatic drainage, and cannot indicated the metastases of lymph node.