Background
Preoperative preparation of the patient with Graves' disease (GD) is crucial to avoid
intraoperative or postoperative complications associated with anesthesia or surgery.
We aimed to evaluate thyroid blood flow and microvessel density in patients with GD
according to antithyroid drug (ATD) treatment, preoperatively.
Method
Forty-three patients were divided into two groups according to the ATD type. Patients
in group 1 (n = 25) were treated with methimazole, whereas patients in group 2 (n
= 18) were treated with propylthiouracil, preoperatively. Blood flow through the thyroid
arteries was measured by color flow Doppler ultrasonography. The microvessel density
(MVD) was assessed immunohistochemically and via Western blot analysis using the level
of CD-34expression in thyroid tissue.
Results
There was a positive correlation between blood loss and thyroid volume (rs = 0.953, P = .0001) and blood flow (rs = 0.720, P = .0001) and CD-34 expression (rs = 0.331, P = .03) and MVD (rs = 0.442, P = .003). No correlation was observed between ATD type and thyroid vascularity. In
patients with longer treatment duration before operation, thyroid vascularity was
significantly lower relative to patients with shorter treatment durations. According
to logistic regression analysis, longer treatment duration had a 142-fold decreased
rate of intraoperative blood loss independent of ATD type.
Conclusion
Preoperative ATD treatment duration may predict intraoperative blood loss during thyroidectomy.
Longer treatment duration might be useful in reducing intraoperative bleeding, allowing
better visualization and preservation of the nerves and parathyroid glands.
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Article info
Publication history
Published online: December 21, 2007
Accepted:
July 26,
2007
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
