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UCLA Health - Total thyroidectomy and thyroid lobectomy | UCLA Endocrine Center

Thumbnail of the video “UCLA Health - Total thyroidectomy and thyroid lobectomy | UCLA Endocrine Center”
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Author: UCLA Health
Categories: Health
Tags: health
Views: 2 · Last viewed: 2026-10-16 15:00 UTC

Short Summary

Main recommendation: The video presents two surgical options for thyroid cancer tumors under about four centimeters: total thyroidectomy (removal of the entire thyroid gland) or thyroid lobectomy (removal of only one half, also called partial thyroidectomy), with the choice depending on personal risk factors and needs made together with the endocrine care team. Total thyroidectomy is presented as better for ongoing monitoring and high-risk cases, while lobectomy is presented as better for minimizing surgical complications and avoiding lifelong hormone supplementation.

Key Points

  • Total thyroidectomy allows monitoring for recurrence with the thyroglobulin blood test, which only works after the entire thyroid is removed, and it permits radioactive iodine ablation if high-risk features such as tumor growth outside the thyroid or lymph node spread are found.
  • Total thyroidectomy carries a risk of temporary (about 5 percent) or permanent (up to 1 percent) recurrent laryngeal nerve injury causing hoarseness, up to 1 percent permanent hypoparathyroidism requiring calcium supplements, and mandatory lifelong thyroid hormone replacement.
  • Thyroid lobectomy still removes the cancer completely and puts only one recurrent laryngeal nerve at risk, with no risk of low parathyroid hormone because one side of the neck is untouched.
  • After lobectomy, about 50 to 60 percent of patients still need some thyroid hormone to keep the body's demand low and prevent stimulation of remaining thyroid cell growth.
  • Lobectomy carries about a 50 percent chance of needing a completion thyroidectomy later (quoted elsewhere as about 15 percent risk), usually when high-risk features are found and radioactive iodine is wanted, and the thyroglobulin test cannot be used for surveillance, so frequent neck ultrasounds are used instead.

Details Worth Noting

  • Concrete instructions: The speaker gives no step-by-step treatment protocol. Actionable guidance is to decide between the two options with your endocrine care team, weighing your tumor size and risk factors. Choose total thyroidectomy if you already take thyroid hormone and want the added assurance of blood-test and ultrasound monitoring. Choose lobectomy if you want to minimize surgical complication risk, avoid extra thyroid hormone after surgery, and accept a possible second surgery (quoted as about a 15 percent risk). To arrange a consultation, submit a request on the UCLA Endocrine Center website or call the clinic, and visit the website for more information about thyroid disease and surgery.
  • The tumor size threshold discussed is less than four centimeters, described as about the size of a walnut or an Oreo cookie.
  • Total thyroidectomy makes lifelong thyroid hormone replacement absolutely necessary.
  • The speakers are endocrine surgeons Kyle Zanaco and James Wu of the UCLA Endocrine Center.

Bottom Line

The choice between the two surgeries is a trade-off: total thyroidectomy favors long-term monitoring and treatment flexibility at the cost of permanent hormone therapy and higher complication risk, while lobectomy favors lower complication risk and less medication but may lead to a second surgery.