The effect of anti-thyroid drug treatment duration on thyroid gland microvessel density and intraoperative blood loss in patients with Graves' disease

Erbil, Yeşim; Giriş, Murat; Salmaslıoğlu, Artür; Özlük, Yasemin; Barbaros, Umut; Yanık, Burcu Tulumoğlu; Kapran, Yersu; Abbasoglu, Semra; Özarmağan, Selçuk

doi:10.1016/j.surg.2007.07.036

Cited by 25 publications

(24 citation statements)

References 19 publications

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“…Furthermore, color Doppler US appears to be useful in the follow-up of GD during medical treatment (2). Color Doppler US is a widely established imaging technique in the evaluation of thyroid gland vascularity because of its low cost and easy approach (4). This technique can depict the pattern of vascularization and provide flow parameters of the feeding vessels (2); however, it may not allow for satisfactory examinations in all patients, and the results depend on the experience of the examiner (5).…”

mentioning

confidence: 99%

Autoimmune Thyroid Disease: Arterial Spin-labeling Perfusion MR Imaging

Schraml¹,

Müssig²,

Martirosian³

et al. 2009

Radiology

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mentioning

confidence: 99%

Autoimmune Thyroid Disease: Arterial Spin-labeling Perfusion MR Imaging

Schraml¹,

Müssig²,

Martirosian³

et al. 2009

Radiology

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“…Erbil Y et al reported that the mean blood flow, MVD, CD-34 expression, and blood loss in group 1 patients were significantly lower than those in group 2 patients. 8 There was a negative correlation between 7), female gender (OR 1.5) and specimen weight (OR 1.6) were independent predictors. However, the extent of surgical resection (OR 2.7), Graves' disease (OR 1.8), recurrent goiter (OR 1.5) and malignant disease (OR 1.5) were independent risk factors for permanent hypoparathyroidism.…”

Section: Discussionmentioning

confidence: 89%

Predictive factors for intraoperative excessive bleeding in multinodular goitre with or without hyperthyroidism

Sagar¹,

Ravikumara²,

Malipatil³

2018

Int Surg J

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Background: Multinodular goitre disease frequently results in and is the most common cause of hyperthyroidism. It also often results in an enlarged thyroid. It also known as toxic diffuse goiter, is an autoimmune disease that affects the thyroid. This study evaluates all the factors that cause intra-operative blood loss and how it affects the Grave’s disease.Methods: This study was conducted in Raichur Institute of Medical Sciences Raichur on 200 patients with multinodular goitre disease, who underwent thyroidectomy during the period between November 2010 to July 2015.Results: The majority of patients were females which constitute about 76.3% with a median age of 33 years. The median period between the onset of the disease and operation was 15 months. Weight of thyroid in grams was 40. Post-operative hospital stay was 4 hours. Univariate analysis revealed that the strongest correlation of AIOBL was noted with the weight of thyroid (p <0.001). Additionally, AIOBL was correlated positively with the period between disease onset and surgery (p <0.001) and negatively with preoperative free T4 (p <0.01). Occurrences of postoperative complications, such as recurrent laryngeal nerve palsy or hypoparathyroidism, and postoperative hospital stay were not correlated with AIOBL.Conclusions: For multinodular goitre, for excessive bleeding during surgery, a large goiter presented as a predictive factor, and transfusion of blood should be considered in cases in which goitre weighs more than 200 g.

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“…This minimizes the risk of excessive blood loss and damage to nerves or parathyroid glands 18,[40][41][42][43] . On the contrary, studies by Lennquist in 1985 42 and Adlerberth in 1987 43 reported no difference in the consistency and vascularity of thyroids prepared with beta-blockers compared with those prepared with ATD.…”

Section: Resultsmentioning

confidence: 99%

“…This regimen, however, has been reported to result in a larger, more vascular and friable gland due to thyrotropin (TSH) stimulation of the thyroid in response to ATD-induced hypothyroidism 15,13 . This unwanted effect can be lessened by increasing the duration of treatment 13,18 or through the use of iodine 1 . In supra-physiological doses, Lugol's iodine inhibits thyroid hormone synthesis via the Wolff-Chaikov effect, and the release of preformed hormones 3,15 .…”

Section: Discussionmentioning

confidence: 99%

Beta-blockers and the thyrotoxic patient for thyroid and non-thyroid surgery: A clinical review

Tay¹,

Khoo²,

Tancharoen³

et al. 2013

OA Anaesthetics

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IntroductionThyrotoxic patients presenting for surgery should ideally be biochemically and clinically euthyroid. This is conventionally achieved through the use of anti-thyroid drugs, beta-blocker therapy and iodine. However, there are some circumstances where antithyroid drugs may not be a viable option. The implications of this scenario are not widely reported in the literature. This clinical review looks at the evidence on the safety of beta-blocker therapy without the use of antithyroid drugs in the preparation of the thyrotoxic patient for surgery. We also highlight key points in the pathophysiology of thyrotoxicosis and the management goals of these patients. ConclusionIn circumstances where the use of anti-thyroid drugs is not possible in the preoperative management of patients for thyroid or non-thyroid surgery, the use of beta-blockers has been shown to be safe and effective. Safety can be increased by using iodine with or without corticosteroids up to the day of surgery in the rapid preoperative preparation of a severely thyrotoxic patient.

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The effect of anti-thyroid drug treatment duration on thyroid gland microvessel density and intraoperative blood loss in patients with Graves' disease

Cited by 25 publications

References 19 publications

Autoimmune Thyroid Disease: Arterial Spin-labeling Perfusion MR Imaging

Autoimmune Thyroid Disease: Arterial Spin-labeling Perfusion MR Imaging

Predictive factors for intraoperative excessive bleeding in multinodular goitre with or without hyperthyroidism

Beta-blockers and the thyrotoxic patient for thyroid and non-thyroid surgery: A clinical review

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