Application of Nano-carbon Tracer in Da Vinci Robot-assisted Radical Thyroidectomy

Abstract

Objective To evaluate the effect of nano-carbon tracer on lymph node dissection and protection of parathyroid gland and recurrent laryngeal nerve in Da Vinci robot-assisted radical thyroidectomy. Methods Sixty patients who underwent Da Vinci robot-assisted radical thyroidectomy were randomly divided into research group(n=30) and control group(n=30). The control group received conventional Da Vinci robot-assisted radical thyroidectomy, while the research group added nano-carbon tracer during operation. The total and positive number of lymph node dissection in area Ⅵ, the level of serum calcium and PTH, and the incidence of hypocalcemia, hypoparathyroidism, mistaken dissection of parathyroid gland and recurrent laryngeal nerve injury were compared between the two groups after surgery. Results The total lymph nodes in area Ⅵ of research and control groups were 247 and 173(Z=-2.228, P=0.026), the positive lymph nodes were 99 and 65(Z=-1.986, P=0.047), respectively; the levels of serum calcium and PTH decreased on the first day and second day after surgery, compared with the last day before surgery in both groups, but the levels of serum calcium and PTH in the research group were higher than those in the control group on the first day and second day after surgery(P < 0.05). There were 4(13.3%)and 11(36.7%) cases of temporary hypoparathyroidism after surgery in the research group and the control group(P < 0.05). Conclusion The application of nano-carbon tracer in Da Vinci robot-assisted radical thyroidectomy could better improve the dissection of lymph node in area Ⅵ and effectively protect parathyroid glands, but it has no definite protective effect on recurrent laryngeal nerve.

Keywords

• nano-carbon
• thyroid carcinoma
• da vinci robot
• lymph nodes
• parathyroid glands
• laryngeal recurrent nerve