Meta-analysis Of The Effect Of Carbon Nanoparticles In The Operation Of CN0 Stage Papillary Thyroid Carcinoma

Research Objectives:In this paper,the feasibility and safety of nano-carbon in the operation of Papilary thyroid carcinoma（PTC）patients with clinical node-ode-negative（c N0）were investigated by meta-analysis.Whether nano-carbon can reduce the rate of misexcision of parathyroid gland,reduce Transient hypoparathyry oidism（TH）,improve the thorality of lymph node dissection,and reduce Recurrent laryngeal nerve,To evaluate the clinical value of nano carbon in Prophylactic central neck dissection（PCND）of c N0 phase PTC.Research methods:Relevant literatures were searched in wanfang Database,Pub Med,China Biology,EMbase and dozens of other databases,covering all Chinese and English literatures.The retrieval period was from the establishment of the database to January 2022.In the retrieval process,all the relevant content of c N0 phase PTC application carbon nanoline PCND was searched.According to the standardized process,quality screening and practicability evaluation were carried out for the retrieved articles,and qualified literature data were extracted for meta analysis.Data analysis was performed by Rev Man 5.3.Lymph nodes were divided into carbon nanoparticles group and control group according to whether carbon nanoparticles suspension was used to trace lymph nodes.The difference of outcome indexes between the carbon nano group and the control group was analyzed in the number of parathyroid gland misresection,the number of TH occurrence,the number of lymph node dissection per capita,and the number of temporary RLN injury.According to the heterogeneity,fixed effect model and random effect model were used to analyze the results.The measurement data were compared using standardized mean difference（SMD）,the count data were compared using odds ratio（OR）,and the statistical results were expressed with95%CI.And create a forest map for each result.If the number of included references was >10,a funnel plot was established for the results.Results:A total of 15 studies were included,and the results of meta analysis showed that :（1）a total of 9 studies provided data on the number of cases of misexcised parathyroid gland,including 1296 subjects,652 in the carbon nanogroup and 644 in the control group.The incidence of parathyroid misresection in the carbon nanogroup was lower than that in the non-carbon nanogroup.[OR=0.21,95%CI（0.13,0.33）,P<0.00001];（2）A total of 12 literatures provided data on the number of TH cases.A total of 1616 subjects were included,including 808 in the carbon nano group and 808 in the control group.The incidence of TH in carbon nanogroup was lower than that in non-carbon nanogroup [OR=0.37,95%CI（0.28,0.48）,P<0.000 01].（3）A total of 10 literatures provided data on the number of lymph node dissection per capita,including 1495 subjects,750 in the carbon nano group and 745 in the control group.The carbon nano group had a higher number of lymph node dissection per capita.[SMD=1.47,95%CI（1.11,1.83）,P<0.00001];（4）A total of 11 literatures provided data on the number of RLN injury cases,including 1582 subjects,792 in the carbon nano group and 790 in the control group.The incidence of temporary RLN injury in the carbon nanogroup was lower than that in the non-carbon nanogroup [OR=0.39,95%CI（0.26,0.59）,P<0.000 01].Conclusion:The application of carbon nanoparticles in the operation of c N0 stage PTC can reduce the intraoperative damage of parathyroid gland and RLN to a certain extent and reduce the occurrence of TH on the basis of making PCND more thorough.