Do we really Need Lugol Solution in the Era of Energy Devices for the Preoperative Management of Patients with Graves’ Disease?

J Clin Exp Invest 2019;10(4):em00730.


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Introduction: Inorganic iodide (Lugol solution) has been used for the preoperative management of patients with Graves’ disease for many years. However, some new instruments have come into the surgeons reach that can accomplish bloodless operative field without the need of preoperative treatment. The purpose of this prospective study was to evaluate the efficacy and safety in the application of two types of energy devices – SonoSurg® and Thunderbeat® in patients with and without preoperative preparation with Lugol solution.
Material and Methods: The study included 100 patients with Greaves’ disease operated between January 2017 and December 2017. Patients were divided into four groups - 50 patients operated using SonoSurg® - 25 patients with preoperative preparation with Lugol solution and 25 without preoperative PI preparation, and 50 patients operated using Thunderbeat® - 25 patients with and 25 without preoperative Lugol preparation. We evaluated and compared the outcome between the four groups.
Results: The four groups had a similar distribution in the demographic features such as gender, age, and functional activity. When comparing the results, we found very similar results in the groups with preoperative preparation with PI solution. In contrasts we found significant differences in the duration of surgery, intraoperative and postoperative complications between the groups without preoperative PI preparation. Hospital stay of patients in four groups was similar - an average of 2 days stay into the clinic.
Conclusion: Our results showed that Lugol solution preparation has its place in the era of energy devices. Thunderbeat® can accomplish reliable hemostasis without preoperative Lugol preparation however we can achieve the same result with SonoSurg® and preoperative preparation at a much lower cost.


Graves’ disease, Thunderbeat, Sonosurg, Lugol solution


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Vidinov KN, Stoinov Y. Do we really Need Lugol Solution in the Era of Energy Devices for the Preoperative Management of Patients with Graves’ Disease?. J Clin Exp Invest. 2019;10(4):em00730.