Effect of preoperative potassium iodide administration on Graves' disease surgery: a propensity score analysis

Preoperative administration of a saturated solution of potassium iodide (SSKI) is recommended in the guidelines for the management of hyperthyroidism due to Graves' disease. Studies addressing its effect on complications after thyroidectomy are inconclusive.

Retrospective multicenter Propensity Score study of patients undergoing total thyroidectomy for Graves' disease, from January 2013 to September 2019 in two tertiary centers in Madrid, Spain. Patients were given SSKI prior to surgery or not according to surgeons' preferences. Electronic clinical records were reviewed searching: baseline characteristics surgical variables, pathological findings, and postoperative complications.

Ninety patients were analyzed: 44 received SSKI and 46 were not given SSKI. No significant differences were found in the main postoperative complications with or without SSKI: transient hypoparathyroidism (40.9% vs. 50%), permanent hypoparathyroidism (6.8% vs. 13%), transient recurrent laryngeal nerve (RLN) palsy (2.3% vs. 8.7%), definitive RLN palsy (2.3% vs. 2.2%), or cervical hematoma (2.3% vs. 4.3%).

Preoperative administration of SSKI had no impact on postoperative complications after thyroidectomy for Graves' disease.