Effects of Isthmus-Sparing Lobectomy on Thyroid Function: A Prospective, Multicenter, Comparative Study.

Authors

Wan Wook Kim, Yeong San Jeon, Jihyoung Cho, Jun Ho Lee, Hyun Jo Youn, Su Hwan Kang, Jung Eun Choi, Young Ju Jeong, Dongsik Bae, Moo Hyun Lee, Jee Soo Kim

Published in

Head & neck. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

This prospective study evaluated the impact of isthmus management (isthmus-sparing vs. isthmus-removing lobectomy) on postoperative hypothyroidism risk.
Between January 2022 and March 2023, 326 euthyroid patients with benign or low-risk papillary thyroid cancer were randomized into the isthmus-sparing (IS, n = 164) or isthmus-removing (IR, n = 162) group. Administration of levothyroxine was limited to patients with overt hypothyroidism or symptomatic subclinical hypothyroidism.
TSH levels were significantly lower in the IS group at 3, 6, 12, and 18 months ( $p<0.05$ ). Euthyroidism maintenance was higher in the IS group (62.2% vs. 38.9%, $p=0.001$ ). The IS group showed lower subclinical hypothyroidism (33.8% vs. 54.9%, $p=0.001$ ) and hormone replacement rates (8.5% vs. 25.3%, $p=0.001$ ). Overt hypothyroidism was lower in the IS group without statistical significance (6.1% vs. 12.3%, $p=0.057$ ).
Isthmus-sparing lobectomy better preserves thyroid function and reduces postoperative subclinical hypothyroidism and hormone replacement needs compared to isthmus-removing lobectomy.

PMID:
42861680
Bibliographic data and abstract were imported from PubMed on 12 Oct 2026.

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