Preoperative Potassium Iodide Treatment in Patients Undergoing Thyroidectomy for Graves' Disease-Perspective of a European High-Volume Center

World J Surg. 2020 Oct;44(10):3405-3409. doi: 10.1007/s00268-020-05593-0.

Abstract

Background: Potassium iodide (KI) treatment affects the vascularity of the thyroid gland and therefore may improve intraoperative visualization of essential structures. However, clear evidence for its usage is lacking, and its implementation in patients suffering from Graves' disease is becoming rare. The objective of this retrospective study was to assess the impact of KI treatment on the intraoperative course and the outcome of patients undergoing thyroidectomy for Graves' diseases.

Methods: The study included 442 patients: 125 patients (28.3%) who received a preoperative treatment with KI ("Group KI") and 317 patients (71.7%) without a KI therapy ("Group No-KI"). Indication for KI treatment was a thyroid bruit (82.5%), as well as hyperthyroidism refractive to medical treatment with antithyroid drugs (17.4%).

Results: All patients underwent total thyroidectomy. Permanent vocal cord paresis and permanent hypoparathyroidism were similar in both groups. KI treatment was associated with a significantly longer operative time (142 vs. 128 min, p < 0.001) and a significant higher weight of the thyroid gland. KI treatment did not impact duration of hospital stay or occurrence of secondary hemorrhage.

Conclusions: The complication rate of this study population with clinically severe GD was very low-which may be caused by pre-treatment of patients. The complementary option of a potassium iodide treatment before surgery remains a possibility and should be implemented individually.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Graves Disease / drug therapy
  • Graves Disease / surgery*
  • Humans
  • Hypoparathyroidism / etiology
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications
  • Potassium Iodide / administration & dosage*
  • Potassium Iodide / adverse effects
  • Preoperative Care
  • Retrospective Studies
  • Thyroidectomy* / adverse effects
  • Treatment Outcome
  • Vocal Cord Paralysis / etiology
  • Young Adult

Substances

  • Potassium Iodide