Abstract: Objective To investigate the clinical efficacy of tracing with mitoxantrone hydrochloride in patients undergoing total thyroidectomy combined with bilateral central compartment lymph node dissection.Methods Patients with differentiated thyroid carcinoma who underwent total thyroidectomy combined with bilateral central compartment lymph node dissection between June 2021 and June 2024 at a single medical institution were included.They were randomly assigned to either the mitoxantrone hydrochloride tracer group (MHI group) or the blank control group (control group) in a 1∶1 ratio.The lymph node dissection count,postoperative parathyroid gland (PG) resection count in gross specimens,and postoperative parathyroid hormone (PTH) levels on postoperative days 1d,5d,30d and 6 months were compared between the two groups. Results All 132 patients underwent successful surgery,with 69 in the MHI group and 63 in the control group.There were no cases of bleeding,infection,or permanent recurrent laryngeal nerve injury（P>0.05）.The baseline characteristics and operative time showed no statistically significant differences between the two groups.The mean number of metastatic lymph nodes was 1.93 ± 1.66 in the MHI group and 1.63 ± 1.59 in the control group,with no statistically significant difference (P> 0.05).Intraoperative parathyroid autotransplantation was performed in 12 patients (17.39%) in the MHI group and 6 patients (9.52%) in the control group,with no statistically significant difference (P > 0.05).The number of lymph nodes dissected was 12.55 ± 3.05 in the MHI group and 10.41 ± 2.90 in the control group,showing a statistically significant difference (P< 0.05).Postoperative pathological examination revealed inadvertent parathyroid gland (PG) excision in 3 patients (4.35%) in the MHI group and 11 patients (17.46%) in the control group,with a statistically significant difference (P < 0.05).The proportion of patients with low parathyroid hormone (PTH) levels on postoperative day 1 did not differ significantly between the two groups (P>0.05).In the MHI group,7 (10.14%),3 (4.35%),and 1 (1.45%) patients exhibited low PTH levels on postoperative days 5,30,and at 6 months,respectively.In the control group,the numbers were 15 (23.81%),10 (15.87%),and 6 (9.52%),respectively,showing statistically significant differences (P<0.05).Conclusion The use of mitoxantrone hydrochloride tracing in patients undergoing total thyroidectomy for papillary thyroid carcinoma can enhance the thoroughness of neck lymph node dissection,diminish parathyroid missection,and mitigate the occurrence of parathyroid dysfunction.

Key words: mitoxantrone hydrochloride injection for tracing; differentiated thyroid cancer; parathyroid glands