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Video

Head and Neck Surgery

(A605) Preoperative Lugol's Iodine in Graves' Thyroidectomy: An Updated Systematic Review and Meta-Analysis of Trials

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Emma Ann Finnegan

    Medical Student
    Trinity College Dublin
    Dublin , Dublin, Ireland

    • Co-Author(s)

  • IS

    Iqbal Sayudo, MD

    Medical Research Unit, Universitas Syiah Kuala, Banda Aceh, Indonesia, United States

  • NR

    Numa Rajab, n/a

    Sulaiman AlRajhi University, Qassim, Saudi Arabia, United States

  • MQ

    Marco Quiros, MD

    Universidad Autonoma de Centroamerica, Costa Rica, United States

    • Senior Author(s)

  • CAROLINA JANOVSKY, MD, MBA, PhD

    Assistant Professor
    Endocrinology Unit, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
    SAO PAULO, Sao Paulo, Brazil

Disclosure(s):
Emma Ann Finnegan, n/a: No relevant relationships to disclose.
CAROLINA JANOVSKY, MD, MBA, PhD: No relevant relationships to disclose.


Introduction: Thyroidectomy, a treatment for hyperthyroid states such as nodular goiter or Graves’ disease, carries risks like bleeding and hematoma. Preoperative use of Lugol’s iodine is suggested to reduce blood loss and improve the surgical field. However, recent studies have questioned Lugol’s efficacy. This updated systematic review and meta-analysis evaluates the efficacy of Lugol’s iodine on operative outcomes in thyroidectomy patients.

Methods: A systematic search of PubMed, Embase, and the Cochrane Library was conducted in accordance with PRISMA guidelines to identify randomized controlled trials evaluating outcomes in adult patients with Graves’ disease or goitre resection who received Lugol’s iodine. Evaluated outcomes included blood loss, operative duration, thyroid weight and volume and postoperative complications such as hypoparathyroidism, vocal cord palsy, and hematoma formation.

Results: Five RCTs were included, comprising 199 patients, 108 (54.27%) received iodine-containing regimens, whilst 91 (45.73%) did not receive the solution. A preoperative Lugol’s iodine decreased blood loss (MD -59.21; 95% CI -89.48, -28.94; p = 0.0001; I² = 52%) and mean blood flow (MD -50.80; [95% CI -70.66, -30.94]; p < 0.00001; I² = 0%) as compared to the control group. The duration of surgery (MD -3.89; 95% CI -18.76, 10.99; p = 0.61; I² = 28%), thyroid volume (MD 1.12; 95% CI -2.65, 4.90; p = 0.56; I² = 0%) as well as the incidence of hematomas (MD 1.56; 95% CI 0.27, 9.15; p = 0.62; I² = 0%), vocal cord palsy (MD 1.34; 95% CI 0.05, 35.70; p = 0.86; I² = NA) or development of hypoparathyroidism (MD 0.67; 95% CI 0.24, 1.85; p = 0.43; I² = NA) all did not differ significantly between groups.

Conclusions: Iodine-containing regimens significantly reduce intraoperative blood loss and blood flow during thyroidectomy, offering benefits in enhancing surgical visualization and minimizing morbidity. Despite these advantages, their lack of significant impact on operative duration, thyroid volume, or postoperative complications limits the wider clinical applicability of this agent.