Application of Carbon Nanoparticles in Transoral Endoscopic Thyroidectomy Vestibular Approach for Unilateral Papillary Thyroid Cancer.

IF 1.1 4区 医学 Q3 SURGERY
Wei-Dong Zhang, Qi Le, Ke-Jie Yu, Ying-Chun Wang, Xian-Jiang Wu
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引用次数: 0

Abstract

Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is newly applied technology. Carbon nanoparticles (CNs) are novel lymph node tracers that have been widely used in China to help remove central lymph nodes (CLNs) and protect the parathyroid glands (PGs) in open thyroid cancer surgery. This study is to evaluate the effectiveness and safety of CNs in TOETVA.

Materials and methods: A total of 158 patients who underwent TOETVA with unilateral papillary thyroid carcinoma were enrolled in this study from March 2019 to February 2022. The participants were divided into a CNs group (n=88) and a control group (n=70), based on whether they received a intraoperative injection of CNs or not. Meanwhile, the CNs group were additionally divided into 2 subgroups, leakage subgroup (n=26) and standard subgroup (n=62). The 2 groups and subgroups were compared in terms of patient characteristics, perioperative clinical results, and postoperative outcomes.

Results: All common metrics had no significant differences were found between the CNs group and the control group ( P >0.05). The standard subgroup of CNs group had advantage over the control group on PGs identification (59/62 vs. 59/70 for superior PG, 56/62 vs. 52/70 for inferior PG, P <0.05). Moreover, the standard subgroup harvested more CLNs than the control group (8.97±2.96 vs. 7.47±2.93, P <0.05). More operation time was spent on the leakage subgroup of CNs group than the control group (160.00±17.61 vs. 140.00±13.32, P <0.05). Meanwhile, the leakage subgroup had disadvantage on intraoperative hemorrhage (26.15±10.80 vs. 21.21±7.09, P <0.05) and hospital durations (4.96±0.72 vs. 4.57±0.69, P <0.05). Furthermore, the leakage group identified fewer inferior PG than the control group (7/26 vs. 52/70, P <0.05). Contrary to the standard subgroup, the CLNs of the leakage subgroup was also unsatisfactory compared with the control group (4.96±1.84 vs. 7.47±2.93, P <0.05).

Conclusions: The application of CNs suspension tracing technology has a definite effect in TOETVA. It can improve the thoroughness of lymph node dissection in the central region and enhance recognition of the PG. However, refined extracapsular anatomy is indispensable to prevent CN leakage. Leaked CNs will also be counterproductive to the operation.

碳纳米粒子在经口内窥镜甲状腺切除术前庭入路治疗单侧甲状腺乳头状癌中的应用
背景:经口内镜甲状腺前庭切除术(TOETVA)是一项新的应用技术。碳纳米颗粒(CNs)是一种新型淋巴结示踪剂,在中国已被广泛应用于开放性甲状腺癌手术中帮助切除中央淋巴结(CLNs)和保护甲状旁腺(PGs)。本研究旨在评估CNs在TOETVA中的有效性和安全性:从2019年3月至2022年2月,共有158名单侧甲状腺乳头状癌患者接受了TOETVA手术。根据术中是否注射 CNs,将参与者分为 CNs 组(88 人)和对照组(70 人)。同时,CNs 组又分为两个亚组,即渗漏亚组(26 人)和标准亚组(62 人)。比较两组和亚组的患者特征、围手术期临床结果和术后效果:结果:CNs 组与对照组在所有常见指标上均无显着差异(P>0.05)。CNs 组的标准亚组在 PGs 识别方面优于对照组(PGs 上部识别率为 59/62 对 59/70,PGs 下部识别率为 56/62 对 52/70,PConclusions):CNs 悬浮追踪技术在 TOETVA 中的应用具有确切的效果。它可以提高中央区淋巴结清扫的彻底性,并增强对 PG 的识别。然而,精细的囊外解剖是防止 CN 泄漏的必要条件。漏出的 CN 也会对手术产生反作用。
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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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