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Iodine absorption after intraoperative bowel irrigation with povidone-iodine

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Diseases of the Colon & Rectum

Abstract

PURPOSE: Povidone-iodine is a commonly used intrarectal tumoricidal agent in patients undergoing colorectal surgery. The aim of this study was to assess systemic absorption of total iodine and its effect on thyroid function after intrarectal application. METHODS: Twenty patients with carcinoma of the rectum received intraoperative irrigation with either povidone-iodine (Group A; n=10) or physiologic saline (Group B; n=10). Ten patients with carcinoma of the sigmoid colon (group C) were treated the same as Group A. Electrolyte, total iodine, triiodothyronine, thyroxine, and thyroid-stimulating hormone values were measured in serum preoperatively and before intraoperative irrigation and immediately, ten minutes, 1 hour, 6 hours, 24 hours, and two weeks after irrigation. RESULTS: No significant changes occurred in serum electrolytes. A significant uptake of the total iodine was demonstrated in each group. Total iodine levels examined immediately, ten minutes, and one hour after irrigation in Group C were significantly higher than those examined in Group B. Maximum values were obtained one hour after irrigation in Groups A and B and six hours after irrigation in Group C. No significant changes occurred in triiodothyronine, thyroxine, and thyroid-stimulating hormone levels among the three groups. The decrease in triiodothyronine levels after surgery was demonstrated in each group. We noted a decrease after surgery in thyroxine levels for Groups A and B and in thyroid-stimulating hormone levels for Group B. Those hormones were not affected by the administration of povidone-iodine. CONCLUSION: High serum levels of iodine did not cause organ toxicity, suggesting that a single use of intraoperative bowel irrigation with povidone-iodine may be performed with practically negligible risk.

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Authors and Affiliations

  1. Second Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666, Tokyo, Japan

    Akira Tsunoda M.D., Ph.D., Miki Shibusawa M.D., Ph.D., Goichi Kamiyama M.D., Manabu Takata M.D., Ph.D., Hirotoshi Choh M.D., Ph.D. & Mitsuo Kusano M.D., Ph.D.

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  1. Akira Tsunoda M.D., Ph.D.
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  2. Miki Shibusawa M.D., Ph.D.
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  3. Goichi Kamiyama M.D.
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  4. Manabu Takata M.D., Ph.D.
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  5. Hirotoshi Choh M.D., Ph.D.
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  6. Mitsuo Kusano M.D., Ph.D.
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Supported in part by SRL, Inc., Tokyo, Japan.

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Tsunoda, A., Shibusawa, M., Kamiyama, G. et al. Iodine absorption after intraoperative bowel irrigation with povidone-iodine. Dis Colon Rectum 43, 1127–1132 (2000). https://doi.org/10.1007/BF02236561

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