hormone (PTH) and calcium (Ca) levels], prognosis, and postoperative complications were compared between the two groups.

Retrospective cohort study. The clinical data of 86 patients with cN0 unilateral paramedian isthmus-type PTC admitted to our hospital from March 2022 to February 2024 were analyzed. They were divided into the observation group (single-sided adenoma lobe + isthmus resection, n=39) and the control group (total thyroidectomy, n=47) according to the surgical method. The perioperative conditions, parathyroid function [serum parathyroid hormone (PTH), calcium (Ca) levels], prognosis and surgery outcomes of the two groups were compared using the χ² test or t test.

The incision length, operation time, and hospital stay in the observation group [(6.3±1.2) cm, (75.5±15.6) min, (4.9±1.1) d, respectively] were shorter than those in the control group [(7.7±1.5) cm, (118.4±22.5) min, (6.7±1.7) d, respectively], and intraoperative blood loss (45.4±12.5) ml was less than that in the control group (72.1±14.3) ml (P<0.05). Serum PTH and Ca levels at 7 days after operation were decreased compared with preoperative levels in both groups. The PTH and Ca levels in the observation group at 7 days after operation [(34.2±6.6) pg/ml, (2.2±0.2) mmol/L, respectively] were higher than those in the control group [(23.2±5.4) pg/ml, (2.0±0.1) mmol/L, respectively] (P<0.05). There were no significant differences in distant metastasis rate (2.6% vs. 0.0%) or recurrence rate (7.7% vs. 4.3%) between the two groups (P>0.05). The complication rate in the observation group (12.8%) was lower than that in the control group (40.4%) (P<0.05).

For carefully selected patients with cN0 low-risk PTC adjacent to the isthmus, unilateral lobectomy plus isthmusectomy has advantages in reducing perioperative trauma, preserving parathyroid function, and lowering complications, while achieving similar short-term tumor control to total thyroidectomy.