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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Updated: Sep 12, 2025

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Thyroid Lobectomy Versus Total Thyroidectomy for Papillary Thyroid Cancer.

Joseph Tobias1, Peter Angelos1

  • 1Division of General Surgery and Surgical Oncology, Department of Surgery, The University of Chicago, 5841 S. Maryland Avenue, MC 4052, Chicago, IL 60637, USA.

Advances in Surgery
|August 6, 2025
PubMed
Summary

Papillary thyroid cancer (PTC) management has shifted towards less invasive thyroid lobectomy for low-risk cases. This approach offers similar outcomes to total thyroidectomy while minimizing complications.

Keywords:
Completion thyroidectomyPapillary thyroid cancerThyroid lobectomy

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Cancer Research

Background:

  • Classical papillary thyroid cancer (PTC) is the most common thyroid malignancy with a generally favorable prognosis.
  • Historically, total thyroidectomy and radioactive iodine (RAI) therapy were the standard of care for all PTC cases.
  • Recent decades have seen evolving consensus guidelines impacting surgical management strategies.

Purpose of the Study:

  • To evaluate the implications of de-escalated surgical therapy for papillary thyroid cancer.
  • To compare outcomes between thyroid lobectomy and total thyroidectomy in select low-risk PTC patients.
  • To assess the impact of surgical approach on recurrence rates, survival, and treatment-related morbidities.

Main Methods:

  • Review of current consensus guidelines and historical treatment standards for PTC.
  • Analysis of outcomes data comparing thyroid lobectomy versus total thyroidectomy in low-risk PTC.
  • Assessment of complication rates including recurrent laryngeal nerve injury and hypoparathyroidism.

Main Results:

  • Thyroid lobectomy without postoperative RAI is now recommended for select low-risk PTC.
  • This de-escalated approach may yield equivalent recurrence and survival rates compared to total thyroidectomy.
  • Thyroid lobectomy significantly reduces risks of nerve injury, hypoparathyroidism, and hormone replacement dependency.

Conclusions:

  • Patient selection is critical for determining the optimal surgical approach (lobectomy vs. total thyroidectomy) in PTC.
  • De-escalation of surgical therapy in low-risk PTC offers comparable oncologic outcomes with improved quality of life.
  • The shift towards less extensive surgery reflects advancements in understanding PTC biology and risk stratification.