Study on application value of nano carbon technology in cleaning lymph nodes in the recurrent laryngeal nerve region of cN0 stage PTMC
Objective To study the clinical value of nano carbon technology in cleaning lymph nodes in the recurrent laryngeal nerve(RLN)region of cN0 stage papillary thyroid microcarcinoma(PTMC).Methods 108 patients with cN0 stage PTMC were selected and divided into a control group and an observation group according to random numerical table,with 54 cases in each group.The observation group injected 0.2-0.3 ml of nano carbon suspension into the thyroid gland during lymph node dissection after RLN in PTMC patients,while the control group did not inject nano carbon suspenssion.All patients should undergo at least thyroidectomy and isthmus resection on the affected side,as well as lymph node dissection in the central region of the affected side;for bilateral PTMC patients,total thyroidectomy and double neck central lymph node dissection were performed,with some cases of lateral neck lymph node metastasis also undergoing lateral neck lymph node dissection.Both groups were compared in terms of surgical time,intraoperative bleeding volume,blood calcium(Ca)and serum parathyroid hormone(PTH)levels before and after operation,postoperative complications such as hoarseness,transient hypoparathyroidism and hypocalcemia,average number of lymph nodes detected,number of positive lymph nodes detected,parathyroid misresection and RLN injury.Results There were no significant differences in surgical time and intraoperative bleeding volume between the two groups(P>0.05).Before operation,there were no significant differences in blood Ca and serum PTH levels between the two groups(P>0.05).1 d after operation,the levels of blood Ca and serum PTH in the observation group were(2.28±0.09)mmol/L and(31.02±10.97)ng/L,which were significantly higher than(2.21±0.10)mmol/L and(26.59±11.48)ng/L in the control group(P<0.05).1 month after operation,there were no significant differences in the levels of blood Ca and serum PTH between the two groups(P>0.05).The incidence of hoarseness and hypocalcemia in the observation group were 3.7%and 16.7%,which were significantly lower than 14.8%and 33.3%in the control group(P<0.05).There was no significant difference in the incidence of transient hypothyroidism between the two groups(P>0.05).The average number of lymph nodes detected in the observation group was(7.37±1.82)nodes and the average number of positive lymph nodes detected was(2.41±0.86)nodes,which were higher than(6.57±1.92)and(1.98±0.88)nodes in the control group;the observation group had parathyroid misresection rate of 9.3%and RLN injury rate of 3.7%,which were lower than 24.1%and 14.8%in the control group;there was significant difference(P<0.05).Conclusion The application of nano carbon technology in cleaning the RLN lymph nodes of cN0 PTMC patients has improved the detection rate of lymph nodes,reduced the rate of parathyroid misresection,and protected RLN.It is worthy of promotion.
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