ORIGINAL RESEARCH article
Front. Surg.
Sec. Otorhinolaryngology - Head and Neck Surgery
Preoperative Lugol's Solution and Surgical Outcomes in Graves' Disease: A Single-Center Retrospective Study
Provisionally accepted
Mehmet Taner Ünlü*
Ozan Caliskan
Işık Çetinoğlu
Zerin ŞengülHazal ArikanDüşsel Gerçelman
Nurcihan Aygun
Mehmet Uludag- HEALTH SCIENCE UNIVERSTY ISTANBUL SISLI HAMIDIYE ETFAL TRAINING AND RESEARCH HOSPITAL, Sarıyer, Türkiye
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Abstract Introduction: Basedow Graves disease (BG) is the most common cause of hyperthyroidism. Lugol's solution(LS) is used preoperatively to inhibit thyroid hormone production, decrease thyroid gland vascularity and ensure a safer surgical field. This study aims to evaluate efficacy of the LS and its association with surgical complications in patients with BG. Materials and Methods: Patients with total thyroidectomy for BG between 2019 and 2024 were retrospectively included. Preoperative calcium (Ca), alkaline phosphatase (ALP), parathyroid hormone(PTH) levels, operative time, resected thyroid specimen weights, postoperative complications were analyzed. Results: Among 128 patients, 38(29.6%) received LS (Group1), while 90 (70.3%) did not (Group2). No significant difference was found between groups regarding preoperative Ca, ALP, PTH(p=0.780,p=1.000,p=1.000, respectively). Mean operative times were 147.79±64.66 minutes in Group1, 146.19±35.69 minutes in Group2(p=0.225). Mean thyroid specimen weights were 36.83±26.47g in Group1, 43.16±30.81g in Group2(p=0.246). The rates of incidental parathyroidectomy were 21.1%(n=8) in Group1 and15.6%(n=14) in Group2(p=0.456). Transient hypoparathyroidism rate was slightly higher in Group1 (34.2%, n=13) than in Group2 (23.3%,n=21) (p=0.292). Permanent hypoparathyroidism occurred in 2.63% of Group1 and 8.89% of Group2 patients (p=0.375). The rates of postoperative vocal cord paralysis, adjusted for the number of nerves at risk, were comparable between the groups (9.21%,8.89%;p=1.000). Conclusion: The primary endpoint of postoperative hypocalcemia/hypoparathyroidism did not differ significantly between groups. Although the incidence of transient hypoparathyroidism was slightly higher in the LS group, no statistically significant difference was observed. Additionally, no significant difference was found regarding intraoperative or long-term outcomes. Present study did not demonstrate a protective effect of preoperative LS on surgical complications in patients with BG.
Keywords: Endemic goiter, Graves' disease, Lugol's solution, Preoperative preparation, surgicaloutcomes, Thyroidectomy
Received: 27 Nov 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Ünlü, Caliskan, Çetinoğlu, Şengül, Arikan, Gerçelman, Aygun and Uludag. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mehmet Taner Ünlü
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