The Role of Carbon Nanoparticles in Lymph Node Dissection and Parathyroid Gland Preservation during Surgery for Thyroid Cancer: A Systematic Review and Meta-Analysis

SIMPLE SUMMARY: The incidence of thyroid cancer has been increasing over the past few years. Surgery remains still the primary therapeutic option and lymph node dissection is often required. The aim of this study was to perform a meta-analysis of the available data on carbon nanoparticles, a novel agent that can be used to identify lymph nodes intraoperatively more efficiently, while also promoting the protection of the parathyroid glands by reducing the rate of accidental removal. Based on our study, carbon nanoparticles significantly increase the number of lymph nodes harvested during thyroid surgery, while they decrease the accidental removal of parathyroid glands removal rate by 34%. Thus, we suggest their use on a wider basis so that more data can be available for future research on the subject. ABSTRACT: Thyroid cancer is the most common endocrine malignancy with an increasing incidence over the past few years. Surgery is considered the primary therapeutic option, which often involves lymph node dissection. The aim of this study was to assess the role of carbon nanoparticles, a novel agent, in thyroid cancer surgery. For that purpose, we conducted a systematic review of the literature on MEDLINE, EMBASE, Scopus, Cochrane and Google Scholar databases from 1 January 2002 to 31 January 2022. Ultimately, 20 articles with a total number of 2920 patients were included in the analysis. The outcome of the analysis showed that the use of carbon nanoparticles is associated with a higher number of harvested lymph nodes (WMD, 1.47, 95% CI, 1.13 to 1.82, p < 0.001) and a lower rate of accidental parathyroid gland removal (OR 0.34, CI 95% 0.24 to 0.50, p < 0.001). Based on these results, we suggest that carbon nanoparticles are applied in thyroid cancer surgery on a wider scale, so that these findings can be confirmed by future research on the subject.