Abstract
To evaluate the effectiveness of tracer mitoxantrone hydrochloride injection (MHI) in mapping central lymph nodes and its role in preserving parathyroid function during endoscopic radical resection of thyroid carcinoma. A retrospective analysis was conducted on 82 patients with primary papillary thyroid carcinoma (PTC) who were treated at the Department of General Surgery, Gansu Provincial People's Hospital, from May, 2022 to May, 2024. All patients underwent endoscopic total thyroidectomy with central lymph node dissection (CLND), with 42 receiving intraoperative tracer mitoxantrone hydrochloride injection (observation group) and 40 not receiving the injection (control group). Postoperative metrics compared between the two groups included the number of central lymph nodes dissected, the number of metastatic lymph nodes, the incidence of parathyroid gland misdissection, serum parathyroid hormone (PTH) levels, and blood calcium levels. Both groups successfully completed the surgeries. The observation group exhibited a higher number of central lymph nodes dissected and metastatic lymph nodes detected compared to the control group (P < 0.05). Additionally, the rate of parathyroid misdissection was significantly lower in the observation group (P < 0.05). From 1 week to 6 months post-operation, the observation group showed significantly higher PTH levels than the control group (P < 0.05). Similarly, blood calcium levels were significantly elevated in the observation group over the same period (P < 0.05). The incidence of temporary and permanent hypoparathyroidism was also significantly lower in the observation group (χ(2) = 6.071, P = 0.033). The application of MHI during endoscopic radical resection of PTC enhances the identification and dissection of both central and metastatic lymph nodes, thereby reducing the risk of postoperative recurrence. It helps to identify the parathyroid glands, reduces the rate of parathyroid miscarriage, reduces the occurrence of postoperative complications, and has clinical promotion value.