Rapid preparation of hyperthyroid patients for thyroidectomy

Abstract

Objective: Preoperative preparation of hyperthyroid patients is extremely important to avoid complications due to severe thyrotoxicosis during surgery. We investigated the effects of lugol's solution (LS) with or without thionamides in the rapid preparation of the patients for thyroid surgery and compared the effect of LS in patients with Graves' disease (GD) and toxic multinodular goiter (TMNG). Material and Methods: Data were collected retrospectively from 44 patients with hyperthyroidism who were followed up in our clinic. Twenty-two patients with GD, 19 patients with TMNG and three patients with solitary toxic adenoma were enrolled into the study. To restore euthyroidism before surgery, 27 patients were treated with LS (group 1) while 17 patients received LS and thionamides (group 2). Results: Mean daily total dosage of LS and duration of treatment to restore euthyroidism were not statistically different between groups 1 and 2. When the two treatment groups were compared, there was no significant difference in baseline parameters and percentage of changes of serum fT4 and fT3 levels. Duration of LS treatment and dosages of LS and thionamides were also similar in patients with GD and TMNG. Percentage of changes in serum fT4 and fT3 levels after LS treatment were not statistically different in two groups of patients. All patients were clinically euthyroid before surgery. Condusion: LS treatment, either alone or together with antithyroid drugs, is a safe and effective choice for the rapid preparation of hyperthyroid patients for thyroidectomy, independent from the etiology of hyperthyroidism.