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Authors Wang L, Yang D, Lv JY, Yu D, Xin SJ
Received 23 December 2016
Accepted for publication 20 January 2017
Published 27 February 2017 Volume 2017:10 Pages 1247—1260
DOI https://doi.org/10.2147/OTT.S131012
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 2
Editor who approved publication: Dr Yao Dai
Purpose: To investigate whether carbon nanoparticles (CNs) are helpful in
identifying lymph nodes and metastatic lymph nodes and in parathyroid
protection during thyroid cancer surgery.
Methods: English and Chinese literature in PubMed, Cochrane
Database of Systematic Reviews, EMBASE, ClinicalTrials.gov, China Biology
Medicine Database, China National Knowledge Infrastructure, China Master’s and
Doctoral Theses Full-Text Database, Wanfang database, and Cqvip database were
searched (till March 22, 2016). Randomized controlled trials (RCTs) that
compared the use of CNs with a blank control in patients undergoing thyroid
cancer surgery were included. Quality assessment and data extraction were
performed, and a meta-analysis was conducted using RevMan 5.1 software. The
primary outcomes were the number of retrieved central lymph nodes and
metastatic lymph nodes, and the rate of accidental parathyroid removal.
Results: We obtained 149 relevant studies, and only 47 RCTs
with 4,605 patients (CN group: n=2,197; blank control group: n=2,408) met the
inclusion criteria. Compared with the control group, the CN group was
associated with more retrieved lymph nodes/patient (weighted mean difference
[WMD]: 3.39, 95% confidence interval [CI]: 2.73–4.05), more retrieved
metastatic lymph nodes (WMD: 0.98, 95% CI: 0.61–1.35), lower rate of accidental
parathyroid removal, and lower rates of hypoparathyroidism and hypocalcemia.
However, the total metastatic rate of the retrieved lymph nodes did not differ
between the groups (odds ratio: 1.13, 95% CI: 0.87–1.47, P =0.35).
Conclusion: CNs can improve the extent of neck dissection and
protect the parathyroid glands during thyroid cancer surgery. And the number of
identified metastatic lymph nodes can be simultaneously increased.
Keywords: carbon nanoparticles, lymph node
tracer, thyroid cancer, parathyroid, meta-analysis