THE ROLE OF LUGOL SOLUTION BEFORE TOTAL THYROIDECTOMY FOR BASEDOW DISEASE: A RANDOMIZED CLINICAL TRIAL

AUTHORS:
D. Schiavone (Padova, Italy) , F. Torresan (Padova, Italy) , S. Dughiero (Padova, Italy) , J.L. Carrillo Lizarazo (Padova, Italy) , F. Crimi' (Padova, Italy) , G.M. Pennelli (Padova, Italy) , D. Sacchi (Padova, Italy) , S. Censi (Padova, Italy) , C. Mian (Padova, Italy) , M. Iacobone (Padova, Italy)
Background:
Lugol solution (LS) is often administrated preoperatively in patient with Basedow disease (BD), aiming to reduce thyroid vascularization and surgical morbidity, but its real effectiveness remains controversial. This study was aimed to evaluate the effects of preoperative LS on thyroid vascularization and surgical morbidity in patients with BD
Methods:
Fifty-six patients undergoing total thyroidectomy for BD by a single experienced surgeon were enrolled in a prospective, monocentric, single-blinded cohort trial and randomly assigned to receive preoperative (7 days) LS treatment (LS+ Group, n=29) or no LS treatment (LS- Group, n=27). Preoperative hormonal, color-doppler ultrasonographic data (assessing thyroid vascularization), were assessed 7 days before surgery (T0) and the day of surgery (T1). Intra and post-operative blood loss, length of surgery, and morbidity were assessed. Histopathological findings (micro-vessel density at immunohistochemistry) were also assessed at final pathology.
Results:
No differences in demographics, preoperative hormonal and ultrasonographic data were found between LS+ and LS- at T0. FT3 and FT4 were significantly reduced at T1 compared to T0 in LS+ (p=0.02) while no significant variations occurred in LS-. No differences between T0-T1 were found for ultrasonographic vascularization data in both groups. Histopathological finding did not differ between LS+ and LS-. No significant differences were found between LS+ and LS- concerning intra/postoperative blood loss (80.5 vs 94ml, respectively), length of surgery (75' in both groups), and postoperative morbidity
Conclusions:
LS significantly reduces FT3, FT4 in patient undergoing surgery for BD but doesn't decrease intra/postoperative blood loss, thyroid vascularization, length of surgery and morbidity.