Is Potassium Iodide Solution Necessary Before Total Thyroidectomy for Graves Disease?

Shinall, Myrick C.; Broome, James T.; Baker, Arielle L.; Solórzano, Carmen C.

doi:10.1245/s10434-013-3126-z

Cited by 35 publications

(43 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Within this group of hyperthyroid patients, those treated with Lugol's potassium iodide drops, had ophthalmopathy, or had the presence of antithyroglobulin antibodies preoperatively, were noted to have more difficult operations based on the TDS system. Potassium iodide (KI) is currently administered preoperatively to Graves' disease patients to reduce gland vascularity and diminish blood loss during thyroidectomy, per current American Thyroid Association guidelines (36). Among our study's patient population, Lugol's potassium iodide was selectively administered preoperatively to patients with Graves' disease and those blocked with anti-thyroid medications.…”

Section: Discussionmentioning

confidence: 99%

Identifying Predictors of a Difficult Thyroidectomy

Mok

Oltmann

Chen

et al. 2014

Journal of Surgical Research

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Identifying Predictors of a Difficult Thyroidectomy

Mok

Oltmann

Chen

et al. 2014

Journal of Surgical Research

View full text Add to dashboard Cite

show abstract

“…For example, Graves' disease leads to increased vascularity and friability of thyroid gland. 22 Fibrosis, another component of the TDS, is seen in Hashimoto's thyroiditis. Larger gland size contributes to higher complication rates, specifically airway complications and transient hypocalcemia.…”

Section: During the Late 19mentioning

confidence: 99%

Predicting difficulty of thyroidectomy preoperatively

Oommen

Remin

2017

Int Surg J

View full text Add to dashboard Cite

Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care.Methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied.Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive anti-thyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomyConclusions: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

show abstract

“…Shinall et al [2] performed a retrospective case-note analysis of patients undergoing total thyroidectomy. The 2 groups of patients under study were those who had a diagnosis of Graves' disease and those diagnosed with toxic multi-nodular goitre (TMNG).…”

Section: Analysis Of the Literaturementioning

confidence: 99%

“…Are there any differences in post-operative outcome following total thyroidectomy in patients who have Graves' disease who do not receive preoperative iodine treatment and in those who undergo total thyroidectomy for a TMNG? Shinall et al [2] have clearly defined the cases and comparison group. There does not appear to have been a power calculation in this particular study, increasing the likelihood of a type II error; however, they performed statistical analysis using Student's t test, the χ 2 test and multivariate analysis.…”

Section: Analysis Of the Literaturementioning

confidence: 99%

See 1 more Smart Citation

Pre-Operative Lugol's Iodine Treatment in the Management of Patients Undergoing Thyroidectomy for Graves' Disease: A Review of the Literature

Hope

Kelly

2016

Eur Thyroid J

View full text Add to dashboard Cite

Objective: To undertake a review of the relevant English literature published on the pre-operative use of Lugol's iodine in the management of patients undergoing thyroidectomy for Graves' disease. Search Strategy: We reviewed all relevant papers found through Ovid Medline, PubMed, EMBASE and the American Thyroid Association website. Searches were limited to the English language only. Evaluation Method: The critical appraisal tool CASP was used to help analyse the papers. Following this, the evidence was ranked using the Harbour and Miller classification of hierarchy. Results: Four papers were deemed appropriate for analysis. The evidence contained within the review is considered weak. The literature available in the public domain regarding the use of iodinated solutions in the pre-operative period for those patients about to undergo thyroidectomy for Graves' disease is scant. Conclusion: Having undertaken an extensive literature review, we are of the opinion that the evidence on which the American Thyroid Association's guidance on the use of preoperative Lugol's iodine is based is tenuous. There appears to be little in the way of sound clinical evidence that post-operative outcomes are any different following a course of Lugol's iodine. Given the lack of robust clinical evidence regarding the clinical need for iodine solution in the pre-operative period, it appears clear that a larger, prospective, randomised controlled trial of all relevant outcomes - clinical and scientific - is required to answer whether or not patient preparation with Lugol's iodine is in fact necessary prior to operative intervention for Graves' disease.

show abstract

Is Potassium Iodide Solution Necessary Before Total Thyroidectomy for Graves Disease?

Abstract: Although current ATA recommendations for the management of GD call for routine use of KI before thyroidectomy, this large series demonstrates no appreciable detriment to patient outcomes when this goal is not met.

Cited by 35 publications

References 17 publications

Identifying Predictors of a Difficult Thyroidectomy

Identifying Predictors of a Difficult Thyroidectomy

Predicting difficulty of thyroidectomy preoperatively

Pre-Operative Lugol's Iodine Treatment in the Management of Patients Undergoing Thyroidectomy for Graves' Disease: A Review of the Literature

Contact Info

Product

Resources

About