To compare the effects of endoscopic unilateral lobectomy and open surgery on the postoperative recovery of patients with differentiated thyroid cancer（DTC）.

Data of 105 DTC patients from May 2019 to May 2021 were retrospectively analyzed and divided into endoscopic group（thoracic and breast approach endoscopic unilateral lobectomy，n=48）and open group（open surgery，n=57）according to different surgical methods. SPSS 24.0 software was used for data analysis. Perioperative indicators，pain related indicators，thyroid function indicators，incision recovery indicators and other measurement data were expressed as（

The intraoperative blood loss，total postoperative drainage volume and hospital stay of patients in endoscopic group were significantly less or shorter than those in open group（P<0.05），and the surgical time was significantly longer than that in open group（P<0.05）. Visual Analogue Scale（VAS）scores of patients at 12 h and 24 h after surgery in endoscopic group were significantly lower than those in open group（P<0.05）. The cortisol（Cor）level of patients at 24 h after surgery in endoscopic group was lower than that in open group（P<0.05）. There were no statistically significant differences in the complications between the two groups of patients（P>0.05）. At 6 months after surgery，there were no statistical differences in the levels of blood calcium，parathyroid hormone（PTH）and thyroglobulin antibody（TgAb）between the two groups（P>0.05）. Vancouver Scar Scale（VSS）score and Patient Scar Assessment Scale（PSAS）score were significantly lower in endoscopic group than those in open group（P<0.05）. There were no statistical differences in 2-year progression-free survival，progression-free survival and overall survival rate between the two groups（P>0.05）.

Endoscopic unilateral thyroid lobectomy via thoracic breast approach has small surgical stress injury and is conducive to postoperative recovery and has good postoperative cosmetic effect. Therefore，if conditions permit，thoracic breast approach can be used for DTC treatment.