title: Potential role for carbon nanoparticles identification and preservation in situ of parathyroid glands during total thyroidectomy and central compartment node dissection.
abstract: OBJECTIVE
  To determine the potential role of intraoperative carbon nanoparticles (CN) injections for identification and preservation of parathyroid glands, thereby reducing the postoperative hypocalcaemia.
  
  
  METHODS
  100 patients with thyroid cancer who underwent total thyroidectomy and central compartment node dissection (CCND) were randomly assigned to receive intraoperative injection of (CN) or not for identifying and preserving normal parathyroid glands.
  
  
  RESULTS
  There was no significantly difference for preoperative and postoperative parathyroid hormone (PTH) levels between the CN and control group (P>0.05). The levels of albumin-adjusted serum calcium (AASC) before surgery and at day 1 and 1 month after surgery did not reach the significant difference between the two groups (P>0.05). However, the patients in CN group had the higher level of AASC at day 3 after surgery than those in control group (P=0.044). Transient postoperative hypoparathyroidism occurred in 24 (48%) patients in CN group and 28 (56%) in control groups, respectively (P=0.423). The incidence of transient postoperative hypocalcemia was 20% (10/50) in CN group and 24% (12/50) in control groups, respectively (P=0.629).
  
  
  CONCLUSIONS
  Carbon nanoparticles can make the thyroid gland and the central lymph node black-stained, but no-stained for parathyroid glands. After rapidly identifying parathyroid and distinguishing it from thyroid and lymph nodes by carbon nanoparticles, complete lymph node dissection and preservation of parathyroid glands become feasible during total thyroidectomy with neck lymph node dissection. After identification, strict adherence to capsular dissection remains essential for safe preservation in situ of the parathyroid glands and their blood supply.
authors: Departments of Head and Neck Surgery, Zhejiang Cancer Hospital, Wenzhou Medical University China.
authors: Jialei
authors: J
authors: Gu
authors: Departments of Head and Neck Surgery, Zhejiang Cancer Hospital, Wenzhou Medical University China.
authors: Jiafeng
authors: J
authors: Wang
authors: Departments of Head and Neck Surgery, Zhejiang Cancer Hospital, Wenzhou Medical University China.
authors: Xilin
authors: X
authors: Nie
authors: Departments of Head and Neck Surgery, Zhejiang Cancer Hospital, Wenzhou Medical University China.
authors: Wendong
authors: W
authors: Wang
authors: Departments of Head and Neck Surgery, Zhejiang Cancer Hospital, Wenzhou Medical University China.
authors: Jinbiao
authors: J
authors: Shang
keywords: Parathyroid glands; carbon nanoparticle; identification; lymph node excision; preservation; thyroid neoplasms