{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T20:26:16Z","timestamp":1788639976554,"version":"build-2803163510"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lugol solution is often administered to patients with Graves\u2019 disease before surgery. The aim is to reduce thyroid vascularization and surgical morbidity, but its real effectiveness remains controversial. The present study was designed to evaluate the effects of preoperative Lugol solution on thyroid vascularization and surgical morbidity in patients with Graves\u2019 disease undergoing total thyroidectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-six patients undergoing total thyroidectomy for Graves\u2019 disease were randomly assigned to receive 7 days of Lugol treatment (Lugol+ group, 29) or no Lugol treatment (LS\u2013 group, 27) before surgery in this single-centre and single-blinded trial. Preoperative hormone and colour Doppler ultrasonographic data for assessing thyroid vascularization were collected 8 days before surgery (T0) and on the day of surgery (T1). The primary outcome was intraoperative and postoperative blood loss. Secondary outcomes included duration of surgery, thyroid function, morbidity, vascularization, and microvessel density at final pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No differences in demographic, preoperative hormone or ultrasonographic data were found between LS+ and LS\u2013 groups at T0. At T1, free tri-iodothyronine (FT3) and free thyroxine (FT4) levels were significantly reduced compared with T0 values in the LS+ group, whereas no such variation was observed in the LS\u2013 group. No differences between T0 and T1 were found for ultrasonographic vascularization in either group, nor did the histological findings differ. There were no significant differences between the LS+ and LS\u2013 groups concerning intraoperative\/postoperative blood loss (median 80 versus 94 ml respectively), duration of surgery (75 min in both groups) or postoperative morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lugol solution significantly reduces FT3 and FT4 levels in patients undergoing surgery for Graves\u2019 disease, but does not decrease intraoperative\/postoperative blood loss, thyroid vascularization, duration of surgery or postoperative morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration number<\/jats:title>\n                    <jats:p>NCT05784792 (https:\/\/www.clinicaltrials.gov).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znae196","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T11:14:20Z","timestamp":1721042060000},"source":"Crossref","is-referenced-by-count":12,"title":["Role of Lugol solution before total thyroidectomy for Graves\u2019 disease: randomized clinical trial"],"prefix":"10.1093","volume":"111","author":[{"given":"Donatella","family":"Schiavone","sequence":"first","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, Endocrine Surgery Unit, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Crim\u00ec","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Radiology, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Cabrelle","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Radiology, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmaria","family":"Pennelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Pathology Unit, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Sacchi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Azienda ULSS2, Marca Trevigiana , Treviso ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-8001","authenticated-orcid":false,"given":"Caterina","family":"Mian","sequence":"additional","affiliation":[{"name":"Department of Medicine, Endocrinology Unit, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Torresan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, Endocrine Surgery Unit, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6057-4642","authenticated-orcid":false,"given":"Maurizio","family":"Iacobone","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, Endocrine Surgery Unit, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"2025042810461421200_znae196-B1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s00268-015-3298-8","article-title":"Effectiveness and mechanism of preoperative Lugol solution for reducing thyroid blood flow in patients with euthyroid Graves\u2019 disease","volume":"40","author":"Huang","year":"2016","journal-title":"World J Surg"},{"key":"2025042810461421200_znae196-B2","doi-asserted-by":"crossref","first-page":"1150036","DOI":"10.3389\/fendo.2023.1150036","article-title":"Application of oral inorganic iodine in the treatment of Graves\u2019 disease","volume":"14","author":"Huang","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2025042810461421200_znae196-B3","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.amsu.2016.06.002","article-title":"The effect of preoperative Lugol\u2019s iodine on intraoperative bleeding in patients with hyperthyroidism","volume":"9","author":"Yilmaz","year":"2016","journal-title":"Ann Med Surg"},{"key":"2025042810461421200_znae196-B4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1159\/000450976","article-title":"Pre-operative Lugol\u2019s iodine treatment in the management of patients undergoing thyroidectomy for Graves\u2019 disease: a review of the literature","volume":"6","author":"Hope","year":"2017","journal-title":"Eur Thyroid J"},{"key":"2025042810461421200_znae196-B5","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.1210\/jc.2007-0229","article-title":"Effect of Lugol\u2019s solution on thyroid gland blood flow and microvessel density in the patients with Graves\u2019 disease","volume":"92","author":"Erbil","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"2025042810461421200_znae196-B6","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000490384","article-title":"European Thyroid Association guideline for the management of Graves\u2019 hyperthyroidism","volume":"7","author":"Kahaly","year":"2018","journal-title":"Eur Thyroid J"},{"key":"2025042810461421200_znae196-B7","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1097\/SLA.0000000000003580","article-title":"The American Association of Endocrine Surgeons guidelines for the definitive surgical management of thyroid disease in adults","volume":"271","author":"Patel","year":"2020","journal-title":"Ann Surg"},{"key":"2025042810461421200_znae196-B8","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1056\/NEJMra1510030","article-title":"Graves\u2019 disease","volume":"375","author":"Smith","year":"2016","journal-title":"N Engl J Med"},{"key":"2025042810461421200_znae196-B9","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.1001\/jama.2015.16535","article-title":"Management of Graves disease: a review","volume":"314","author":"Burch","year":"2015","journal-title":"JAMA"},{"key":"2025042810461421200_znae196-B10","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/j.surg.2014.08.062","article-title":"The effects of acupuncture after thyroid surgery: a randomized, controlled trial","volume":"156","author":"Iacobone","year":"2014","journal-title":"Surgery"},{"key":"2025042810461421200_znae196-B11","author":"Sealed envelope"},{"key":"2025042810461421200_znae196-B12","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.4103\/sja.SJA_559_18","article-title":"The CONSORT statements","volume":"13","author":"Cuschieri","year":"2019","journal-title":"Saudi J Anaesth"},{"key":"2025042810461421200_znae196-B13","doi-asserted-by":"crossref","first-page":"zrac102","DOI":"10.1093\/bjsopen\/zrac102","article-title":"Definition and diagnosis of postsurgical hypoparathyroidism after thyroid surgery: meta-analysis","volume":"6","author":"Nagel","year":"2022","journal-title":"BJS Open"},{"key":"2025042810461421200_znae196-B14","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1002\/bjs.9676","article-title":"Importance of in situ preservation of parathyroid glands during total thyroidectomy","volume":"102","author":"Lorente-Poch","year":"2015","journal-title":"Br J Surg"},{"key":"2025042810461421200_znae196-B15","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4103\/2153-3539.68332","article-title":"Digital images and the future of digital pathology","volume":"1","author":"Pantanowitz","year":"2010","journal-title":"J Pathol Inform"},{"key":"2025042810461421200_znae196-B16","first-page":"KC01","article-title":"Preoperative preparation with Lugol\u2019s iodine in thyroidectomy of euthyroid patients\u2014is it really mandatory? An otorhinolaryngologists view","volume":"8","author":"Santosh","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"2025042810461421200_znae196-B17","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1507\/endocrj.K08E-240","article-title":"Preoperative administration of excess iodide increases thyroid volume of patients with Graves\u2019 disease","volume":"56","author":"Yabuta","year":"2009","journal-title":"Endocr J"},{"key":"2025042810461421200_znae196-B18","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.surg.2013.04.064","article-title":"Total thyroidectomy for Graves\u2019 disease: compliance with American Thyroid Association guidelines may not always be necessary","volume":"154","author":"Shinall","year":"2013","journal-title":"Surgery"},{"key":"2025042810461421200_znae196-B19","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.amjsurg.2021.04.023","article-title":"Effect of preoperative potassium iodide administration on Graves\u2019 disease surgery: a propensity score analysis","volume":"222","author":"Barranquero","year":"2021","journal-title":"Am J Surg"},{"key":"2025042810461421200_znae196-B20","doi-asserted-by":"crossref","first-page":"3405","DOI":"10.1007\/s00268-020-05593-0","article-title":"Preoperative potassium iodide treatment in patients undergoing thyroidectomy for Graves\u2019 disease\u2014perspective of a European high-volume center","volume":"44","author":"Lindner","year":"2020","journal-title":"World J Surg"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/111\/8\/znae196\/58904328\/znae196.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/111\/8\/znae196\/58904328\/znae196.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T10:46:27Z","timestamp":1745837187000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/doi\/10.1093\/bjs\/znae196\/7731514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":20,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,12]]},"published-print":{"date-parts":[[2024,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/bjs\/znae196","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8]]},"published":{"date-parts":[[2024,8]]},"article-number":"znae196"}}