Effect of lugol solution on thyroid gland blood flow and microvessel density in the patients with Graves' disease.
BACKGROUND
Although some endocrine surgeons administer Lugol solution to decrease thyroid gland vascularity, there is still not an agreement on its effectiveness.


OBJECTIVE
The aims of this clinical trial are to evaluate thyroid blood flow and microvessel density in patients with Graves' disease who received Lugol solution treatment preoperatively.


METHODS
This was a prospective clinical trial.


METHODS
This clinical trial took place at a tertiary referral center.


METHODS
Thirty-six patients were randomly assigned to receive either preoperative treatment with Lugol solution (group 1, n = 17) or no preoperative treatment with Lugol solution (group 2, n = 19).


METHODS
Blood flow through the thyroid arteries of patients with Graves' disease was measured by color flow Doppler ultrasonography. The microvessel density (MVD) was assessed by immunohistochemical and Western blot analysis of the level of expression of CD-34 in thyroid tissue. The weight and blood loss of the thyroid gland were measured in all patients.


RESULTS
The mean blood flow, MVD, CD-34 expression, and blood loss in group 1 patients were significantly lower than those in group 2 patients. There was a negative correlation between Lugol solution treatment and blood flow (r(s) = -0.629; P = 0.0001), blood loss (r(s) = -0.621; P = 0.0001), MVD (r(s) = -0.865; P = 0.0001), and CD-34 expression (r(s) = -0.865; P = 0.0001). According to logistic regression analysis, Lugol solution treatment resulted in a 9.33-fold decreased rate of intraoperative blood loss.


CONCLUSIONS
Preoperative Lugol solution treatment decreased the rate of blood flow, thyroid vascularity, and intraoperative blood loss during thyroidectomy.
Erbil
Yeşim
Y
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, 34093 Capa/Istanbul, Turkey. yerbil2003@yahoo.com
Ozluk
Yasemin
Y
Giriş
Murat
M
Salmaslioglu
Artur
A
Issever
Halim
H
Barbaros
Umut
U
Kapran
Yersu
Y
Ozarmağan
Selçuk
S
Tezelman
Serdar
S
D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D015153:Blotting, Western; D005260:Female; D006111:Graves Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007150:Immunohistochemistry; D007454:Iodides / Q000008:administration & dosage*; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000187:drug effects*; D012044:Regression Analysis; D013961:Thyroid Gland / Q000098:blood supply* / Q000378:metabolism; D013965:Thyroidectomy; D018608:Ultrasonography, Doppler
D018952:Antigens, CD34; D006490:Hemostatics; D007454:Iodides; C010389:Lugol's solution