American Thyroid Association (ATA) guidelines suggest that thyroid lobectomy (TL) may be used for low-risk, intrathyroidal tumors up to 4 cm in size with no lesions in the contralateral lobe, instead of total thyroidectomy (TT), which was previously preferred for these tumors. TL offers several benefits over TT such as: A lower rate of side effects. It eliminates the risks of permanent hypoparathyroidism and bilateral RLN palsy. It reduces the rates of permanent unilateral RLN palsy (0.6% in TL versus 1.3% in TT). Surgical hypothyroidism after TT requires lifelong levothyroxine (LT4) replacement therapy.
Source: Lamartina L, Grani G, Durante C, Filetti S. Recent advances in managing differentiated thyroid cancer. F1000Research. 2018;7. What clinical considerations must one consider before opting for thyroid lobectomy?
