Superior parathyroid blood supply safety in thyroid cancer surgery: A randomized controlled trial

Kong, Dedi; Wang, Wei; Wang, Mei-Hong

doi:10.1016/j.ijsu.2019.02.019

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…So, CNs may provide help for unexperienced surgeons, but do not value much for those with abundant experiences. Additionally, parathyroid protection requires not only accurate identification and in situ preserving, but also careful protection of its blood supply and venous drainage [30,31]. In the present study, the thyroid tissue was stained black after CN injection while the parathyroid gland was not.…”

Section: Discussionmentioning

confidence: 49%

Do carbon nanoparticles really improve thyroid cancer surgery? A retrospective analysis of real-world data

Liu

Wang

et al. 2020

World J Surg Onc

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Background: Parathyroid protection and central neck dissection (CND) are basic points of thyroid cancer surgery and draw persistent concern. We aimed to evaluate the value of carbon nanoparticles (CNs) for parathyroid gland protection and CND in thyroid surgery for thyroid cancer patients. Methods: A total of 386 consecutive thyroid cancer patients were enrolled in the retrospective study. Three hundred thirty-four patients using CNs intraoperatively were included in the CN group, and 52 patients without using CNs or any other helping agent were included in the control group. Intact parathyroid hormone (iPTH) was examined. Medical records and histopathologic reports were reviewed. Histopathologic examination was performed. Results: There were no statistical significances in demographic and basic surgical information, preoperative iPTH, and serum calcium between the two groups (P > 0.05). In the CN group, the thyroid tissue and central neck lymph nodes were stained black by CNs, while the parathyroid glands were not. Histopathological examination showed that the carbon nanoparticles might accumulated in the subcapsular sinus of lymph nodes compared with the none-stained samples. The staining with CNs did not impact the histopathological examination. There were no significant differences in postoperative hypocalcemia and hypoPT at day 1, 1 month, and half year after surgery between the two groups, respectively. There was a big decline of iPTH level after surgery, whereas the perioperative decreasing amplitude of PTH was not statistically different between the CNs and control group (57.2 ± 28.6 vs 55.7 ± 27.8, P = 0.710). There were 43 patients occurring incidental parathyroidectomy in the CN group (43/334, 12.9%) and 7 patients in the control group (7/52, 13.5%), without significant difference (P = 0.907). There was no significant difference in the number of lymph nodes identified by pathology per patient between the CNs and control group regardless of unilateral and bilateral CND.

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Section: Discussionmentioning

confidence: 49%

Do carbon nanoparticles really improve thyroid cancer surgery? A retrospective analysis of real-world data

Liu

Wang

et al. 2020

World J Surg Onc

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“…In such cases, CNs may not provide practical help for parathyroid protection. Secondly, the artery supply and venous drainage of PGs are also critical to PGs' function (38,39), and utilization of loupe magnification was found to be protective for PGs and their vessels (40). Thus, the effect of CNs on PGs protection may be decreased in robotic thyroid surgery with magnified three-dimensional vision, possibly due to the early identification of PGs and their vessels.…”

Section: Discussionmentioning

confidence: 99%

Preoperative application of carbon nanoparticles in bilateral axillo-breast approach robotic thyroidectomy for papillary thyroid cancer

et al. 2021

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Background: Carbon nanoparticles (CNs) have been used intraoperatively in open thyroid surgery to facilitate central neck dissection and parathyroid protection. However, little attention was paid to the preoperative injection of CNs. Its safety and feasibility remain to be evaluated in bilateral axillo-breast approach robotic thyroidectomy (BABA RT).Methods: In this retrospective cohort study, 114 papillary thyroid cancer patients (PTC) undergoing BABA RT were enrolled from March 2020 to March 2021. In the CNs group (n=64), 0.15 mL of CNs was injected into the thyroid lobules with malignant nodules the day before surgery. Medical records were reviewed and analyzed, including complications of CNs usage, surgical outcomes, central lymph node (CLN) retrieval, and parathyroid glands (PGs)-related parameters.Results: No significant differences were found between the CNs and the control groups in terms of general characteristics and surgical parameters. Complications of CNs were rare in the CNs group. The mean number of retrieved CLN was significantly higher in the CNs group than in the control group (9.48±4.88 vs. 5.40±2.67, P<0.001), as was the mean number of metastatic CLN (2.00±2.56 vs. 1.04±1.70, P=0.018). There were no differences in PGs preserved in situ, PGs autotransplantation, and postoperative PTH levels on the first day and first month (all P>0.05). Conclusions:In patients with PTC undergoing BABA RT, preoperative application of CNs is a safe and feasible method to facilitate central neck dissection. However, the value of the preoperative application of CNs in robotic thyroidectomy needs to be further studied because it has no significant benefit for parathyroid protection.

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“…Mid Blac Sea J Health Sci 2021;7(1):69-73 surgery with the diagnosis of cancer (13)(14)(15). In present study, incidental parathyroidectomy in malignant group (7.9%) was more common than benign group (4.9%).…”

Section: The Effect Of Incidental Parathyroidectomy On Hypocalcemiamentioning

confidence: 45%

The Effect of Incidental Parathyroidectomy on Hypocalcemia in Benign and Malignant Thyroid Patients

Çatal

Özer

Şit

et al. 2021

Middle Black Sea Journal of Health Science

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Objective: Hypocalcemia is characterized by clinical findings resulting from a decrease in serum calcium (Ca2+) and many etiological factors may cause this condition. The most common cause of postoperative hypocalcemia is hypoparathyroidism and the most frequent complication that occurs after thyroid surgery is hypocalcemia. We aimed to investigate the effect of incidental parathyroidectomy on postoperative early hypocalcemia in patients after thyroid surgery. Methods: Retrospectively analyzed the data of patients who underwent thyroidectomy in General Surgery Department of Abant Izzet Baysal University between January 2009 and December 2018. Age, gender, serum Ca2+ and parathormone (PTH) levels were obtained. The histopathological results of thyroidectomy materials were grouped as benign (Group 1) and malignant (Group 2). Results: The study population was consisted of 3841 patients. 3154 patients were in group 1 and 687 patients were in group 2. The postoperative average serum Ca2+ levels of group 1 and 2 were 8.50 mg/dl (6.80-9.80) and 8,50 mg/dl (6.80-9.80), respectively (p=0.996). Postoperative PTH levels of group 1 and 2 were 44.5 ng/l (0-65) and 44.5 ng/l (0-65), respectively (p=0.979). Overall postoperative hypocalcemia (8.4 mg/dL) was observed in 1742 (45.4%) patients. There was no difference in Ca2+ and PTH levels between group 1 and group 2. Incidental parathyroidectomy (%5.4) was performed in 209 of total study population who underwent thyroidectomy. 155 (4.9%) and 54 (7.9%) of the patients in groups 1 and 2, respectively and the incidental parathyroidectomy rates of the groups were statistically different (p=0.02). Conclusion:We think that incidental parathyroidectomy does not stimulate the development of postoperative hypocalcemia.

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Superior parathyroid blood supply safety in thyroid cancer surgery: A randomized controlled trial

Cited by 13 publications

References 16 publications

Do carbon nanoparticles really improve thyroid cancer surgery? A retrospective analysis of real-world data

Do carbon nanoparticles really improve thyroid cancer surgery? A retrospective analysis of real-world data

Preoperative application of carbon nanoparticles in bilateral axillo-breast approach robotic thyroidectomy for papillary thyroid cancer

The Effect of Incidental Parathyroidectomy on Hypocalcemia in Benign and Malignant Thyroid Patients

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