Total thyroidectomy and thyroid lobectomy | UCLA Endocrine Center

Summary

In this video, endocrine surgeons at UCLA discuss two treatment options for thyroid cancer: total thyroidectomy and lobectomy. Total thyroidectomy removes the entire gland, treats cancer, allows for recurrence monitoring, and may require radioactive iodine therapy. It carries risks like nerve damage and lifelong hormone replacement. Lobectomy removes only the affected half, minimizes surgical risks, but may require additional surgery and lacks thyroglobulin monitoring. The choice depends on patient preferences and risk factors.

Takeaways

• 🏥 Kyle and James Wu are endocrine surgeons at the UCLA Endocrine Center.
• 🔍 They discuss two treatment options for thyroid cancer: total thyroidectomy and thyroid lobectomy (partial thyroidectomy).
• 📏 Total thyroidectomy is suitable for tumors less than four centimeters in size.
• 💉 Total thyroidectomy benefits include cancer removal, recurrence monitoring, radioactive iodine therapy eligibility, and prevention of second surgery.
• ⚠️ Risks of total thyroidectomy include nerve damage, hypoparathyroidism, and lifelong thyroid hormone replacement.
• 💊 Thyroid lobectomy is an alternative for patients who want to minimize surgical risks and may not require lifelong thyroid hormone supplements.
• 🔄 Lobectomy involves removing only the affected half of the thyroid gland.
• 🔎 Lobectomy risks include the possibility of needing a completion thyroidectomy and lack of thyroglobulin blood test for monitoring.
• 👨‍⚕️ The choice of treatment should be made in consultation with the endocrine care team.
• 🌐 For more information, patients can visit the UCLA Endocrine Center's website or request a consultation.

Q & A

What are the two treatment options for thyroid cancer discussed in the script?

The two treatment options for thyroid cancer discussed are total thyroidectomy and thyroid lobectomy or partial thyroidectomy.

What is the size of the thyroid tumor that might be eligible for either treatment option?

A thyroid tumor that is less than four centimeters in size, or about the size of a walnut or an Oreo cookie, might be eligible for either treatment option.

What are the benefits of a total thyroidectomy?

The benefits of total thyroidectomy include treating the cancer by removing it, monitoring for recurrence with a thyroglobulin blood test, administering radioactive iodine ablation therapy if the tumor shows high-risk factors, and preventing the need for a second surgery.

What are the risks associated with total thyroidectomy?

The risks of total thyroidectomy include injury to the recurrent laryngeal nerve, permanent hypoparathyroidism, and the need for lifelong thyroid hormone replacement therapy.

Who might be a good candidate for total thyroidectomy?

Total thyroidectomy is a good choice for patients already taking thyroid hormone and those who want the added assurance of being able to monitor for the return of thyroid cancer with a simple blood test and an ultrasound if needed.

What is a thyroid lobectomy or partial thyroidectomy?

A thyroid lobectomy or partial thyroidectomy involves the removal of only the affected half of the thyroid gland, leaving the other half intact.

What are the benefits of a thyroid lobectomy?

The benefits of a thyroid lobectomy include the removal of cancer, the possibility of normal thyroid function with only half of the thyroid, reduced risk to the recurrent laryngeal nerve, and no risk of low parathyroid hormone.

What are the downsides of undergoing a thyroid lobectomy?

The downsides of a thyroid lobectomy include the possibility of needing a completion thyroidectomy if high-risk features are found after the surgery, and the inability to monitor thyroid cancer using the thyroglobulin blood test.

Who might be a good candidate for a thyroid lobectomy?

A thyroid lobectomy is a good operation for patients who want to minimize the risk of surgical complications, hope to not take extra thyroid hormone supplement after surgery, and are okay with the possibility of needing to come back for a second surgery.

What is the likelihood of needing a second surgery after a thyroid lobectomy?

There is about a 50% chance that a patient might need to come back for a completion thyroidectomy after a thyroid lobectomy if high-risk features of thyroid cancer are found after the initial surgery.

How can patients get more information about thyroid disease and surgery?

Patients can get more information by visiting the UCLA endocrine center's website, checking out their other videos, or by scheduling an in-person or telemedicine consultation.