Efficacy and safety of preoperative preparation with Lugol''s iodine solution in euthyroid patients with Graves’ disease (LIGRADIS Trial): Study protocol for a multicenter randomized trial

Muñoz de Nova J.L. ; Franch-Arcas G. ; Mejía-Abril G.P. ; Flores-Ruiz M.E. ; Muñoz-Pérez N. ; Pintos-Sánchez E. ; Guadarrama González F.J. ; Valdés de Anca Á. ; Mercader-Cidoncha E. ; de la Quintana-Basarrate A. ; Osorio-Silla I. ; Ros-López S. (Universidad de Zaragoza) ; Gallego-Otaegui L. ; Santos-Molina E. ; Martínez-Nieto C. ; Gamborino-Caramés E. ; Artés-Caselles M. ; Lorente-Poch L. ; García-Carrillo M. ; Moreno-Llorente P. ; Marín-Velarde C. ; Ortega-Serrano J. ; Martos-Martínez J.M. ; Vidal-Pérez O. ; Luengo-Pierrard P. ; Villar-del-Moral J.M.

Resumen: Background: Currently, both the American Thyroid Association and the European Thyroid Association recommend preoperative preparation with Lugol''s Solution (LS) for patients undergoing thyroidectomy for Graves’ Disease (GD), but their recommendations are based on low-quality evidence. The LIGRADIS trial aims to provide evidence either to support or refute the systematic use of LS in euthyroid patients undergoing thyroidectomy for GD. Methods: A multicenter randomized controlled trial will be performed. Patients =18 years of age, diagnosed with GD, treated with antithyroid drugs, euthyroid and proposed for total thyroidectomy will be eligible for inclusion. Exclusion criteria will be prior thyroid or parathyroid surgery, hyperparathyroidism that requires associated parathyroidectomy, thyroid cancer that requires adding a lymph node dissection, iodine allergy, consumption of lithium or amiodarone, medically unfit patients (ASA-IV), breastfeeding women, preoperative vocal cord palsy and planned endoscopic, video-assisted or remote access surgery. Between January 2020 and January 2022, 270 patients will be randomized for either receiving or not preoperative preparation with LS. Researchers will be blinded to treatment assignment. The primary outcome will be the rate of postoperative complications: hypoparathyroidism, recurrent laryngeal nerve injury, hematoma, surgical site infection or death. Secondary outcomes will be intraoperative events (Thyroidectomy Difficulty Scale score, blood loss, recurrent laryngeal nerve neuromonitoring signal loss), operative time, postoperative length of stay, hospital readmissions, permanent complications and adverse events associated to LS. Conclusions: There is no conclusive evidence supporting the benefits of preoperative treatment with LS in this setting. This trial aims to provide new insights into future Clinical Practice Guidelines recommendations. Trial registration: ClinicalTrials.gov identifier: NCT03980132. © 2021

Idioma: Inglés

DOI: 10.1016/j.conctc.2021.100806

Año: 2021

Publicado en: Contemporary Clinical Trials Communications 22, 100806 (2021), [6 pp]
ISSN: 2451-8654

Factor impacto CITESCORE: 2.7 - Pharmacology, Toxicology and Pharmaceutics (Q3) - Medicine (Q3)

Factor impacto SCIMAGO: 0.748 - Pharmacology (Q2) - Medicine (miscellaneous) (Q2)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Cirugía (Dpto. Cirugía)