Abstract
OBJECTIVE: To evaluate the efficacy of gasless endoscopic thyroidectomy via the trans-subclavian approach in treating unilateral papillary thyroid carcinoma. METHODS: A retrospective analysis was conducted on 140 patients who underwent surgical treatment for unilateral papillary thyroid carcinoma at the Department of Oral-Maxillofacial-Thyroid Oncosurgery, Jilin Cancer Hospital, between February 2023 and August 2024. Patients were divided into the endoscopic (n=70) and open surgery group (n=70). Clinical characteristics, surgical indicators (operation time, number of central lymph node dissections, intraoperative blood loss, 24-hour postoperative drainage volume, indwelling time of drainage tube, surgical cost, length of hospital stay), complication rates, neck discomfort, and incision satisfaction were compared. RESULTS: Patients in the endoscopic group were younger and had a higher proportion of women (p<0.05). The endoscopic group showed significantly longer operation times and higher 24-hour drainage volumes (p<0.05). No substantial differences were observed between groups in intraoperative blood loss, lymph node dissection count, drainage tube retention time, length of hospital stay, surgical cost, and postoperative complication rates (p>0.05). Neck discomfort was considerably lower, and incision satisfaction was significantly higher in the endoscopic group (p < 0.05). CONCLUSION: Gasless endoscopic thyroidectomy via the trans-subclavian approach is a safe and effective treatment for unilateral papillary thyroid carcinoma. It reduces postoperative neck discomfort and improves cosmetic outcomes, making it a viable and promotable surgical option.