Carbon nanoparticles for identification of metastatic lymph nodes around the superior mesenteric artery in transverse colon cancer

Background: Accurate identification of metastatic lymph nodes around the superior mesenteric artery (SMA), with or without metastasis, is vital for surgeons when dissecting lymph nodes in patients with transverse colon cancer. In the current study, we evaluated the prospect of using carbon nanoparticles in identification of lymph nodes around SMA. Methods We recruited a total of 220 patients, with transverse colon cancer, and divided them into two groups. The first group (n=51) was carbon nanoparticle (CN) while the other (n=169) had no carbon nanoparticle (NCN) group. Intraoperative and post-operative data were compared between the groups. Results We found that 117 patients were negative for D1 lymph nodes, while 3.4% were positive for D2 lymph nodes. Additionally, 169 patients were negative for D2 lymph nodes while 10.7% of patients were positive for D3 lymph nodes. Laparoscopy easily identified black-dyed lymph nodes in the CN group. Significantly higher numbers of positive station D3 lymph nodes (0.63 ± 2.43 vs 0.29 ± 1.03, p = 0.006), number of positive station 214 nodes (0.10 ± 0.13 vs 0.08 ± 0.17, p = 0.004), the number of positive lymph nodes (2.69 ± 5.38 vs 1.90 ± 4.22, p = 0.037), and the number of total lymph nodes (39.67 ± 19.33 vs 34.50 ± 18.99, p = 0.037) were found in the CN compared to NCN group. However, we found no significant differences between CN and NCN groups with regards to the number of positive station D1 and D2 lymph nodes. Conclusions We successfully identified metastases 214 LNs around SMA in transverse colon cancer using carbon nanoparticles. These particles have potential to significantly increase the number of positive and negative lymph nodes.