Evaluation of the clinical value of carbon nanoparticles in endoscopic thyroidectomy and prophylactic central neck dissection through total mammary areolas approach for thyroid cancer

BACKGROUND: Carbon nanoparticles (CNs) are tracers used in thyroid surgery of patients with thyroid cancer (TC) to help remove lymph nodes and protect the parathyroid gland. The facilitative effect of carbon nanoparticles in endoscopic thyroidectomy and prophylactic central neck dissection (pCND) has not been reported. METHODS: The protective effect on parathyroid gland (PG) function and the numbers of identified parathyroid glands and central lymph nodes in endoscopic thyroid surgery through the total mammary areolas approach were compared between the CN and control groups. RESULTS: All endoscopic thyroidectomies were successfully completed. No difference was found in either group regarding the general characteristics or operative complications. The mean number of superior PGs and inferior PGs identified in situ or in the dissected central lymph tissues was not different between the groups. The mean number of lymph nodes removed by unilateral CND was greater in the CN group than in the control group. However, there was no difference in the number of harvested lymph nodes when excluding the LNs less than 5 mm, which exhibit an extremely low metastatic rate. CONCLUSION: Carbon nanoparticles do not improve the protective effect on the parathyroid gland, especially the inferior glands, in endoscopic thyroid surgery through the total mammary areolas approach. There is no need to use CNs to facilitate the lymph node harvest in endoscopic prophylactic unilateral CND.