JOURNAL ARTICLE

The role of carbon nanoparticle in lymph node detection and parathyroid gland protection during thyroidectomy for non-anaplastic thyroid carcinoma- a meta-analysis

Shaowei Xu, Zhifeng Li, Manbin Xu, Hanwei Peng
PloS One 2020, 15 (11): e0223627
33170845

OBJECTIVE: To assess the efficiency of the carbon nanoparticles (CNs) in lymph node identification and parathyroid gland (PG) protection during thyroidectomy for non-anaplastic thyroid carcinoma (N-ATC).

METHODS: A systematic literature search for relevant literatures published up to December 2018 in PubMed, EMBASE, Web of Science and Cochrane Library was performed. Both English and Chinese literatures were retrieved and analyzed. Randomized controlled trials or nonrandomized controlled trials comparing the use of CNs with the use of methylene blue or a blank control in patients undergoing thyroidectomy for N-ATC were enrolled in this study. The primary outcomes included the number of lymph nodes harvested, the rate of lymph nodes involved, and the rates of accidental parathyroidectomy, hypoparathyroidism, and hypocalcemia. Weighted mean differences (WMDs), odds ratios (ORs) and risk differences (RDs) were calculated for the dichotomous outcome variables. Between study heterogeneity was tested using the Q tests and the I2 statistics. All analyses were performed using Review Manager (version 5.3.5).

RESULTS: 25 studies comprising 3266 patients were included in this analysis. The total number of lymph nodes harvested in the CNs groups was significantly higher than that in the control groups (WMD, 2.36; 95% CI, 1.40 to 3.32; P <0.01). Administrating CNs was associated with a lower incidence of accidental PG removal (OR = 0.28, 95% CI = 0.21 to 0.37, P<0.01) and lower rates of both postoperative transient hypoparathyroidism (OR = 0.46, 95% CI = 0.33 to 0.64, P <0.01) and transient hypocalcemia (OR = 0.46, 95% CI = 0.33 to 0.65, P <0.01). No significant difference was found concerning lymph node metastatic rates between CNs group and control group. Subgroup analysis indicated that the application of CNs in reoperation thyroidectomy reduced both the rate of transient hypoparathyroidism (OR = 0.21, 95% CI = 0.06 to 0.75, P = 0.02) and the possibility of accidental PGs removal (OR = 0.21, 95% CI = 0.07 to 0.62, P = 0.004, P<0.05).

CONCLUSIONS: The application of CNs in thyroidectomy for N-ATC results in higher number of lymph node harvested and better PG protection during both initial and reoperation thyroidectomy.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
33170845
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"