To analyze and compare the clinical efficacy of supraclavicular open thyroidectomy (SOT) and transaxillary gasless endoscopic thyroidectomy (TGET) in the treatment of papillary thyroid microcarcinoma (PTMC).

A single-center retrospective cohort study was conducted, enrolling 160 PTMC patients from January 2023 to 2025. According to the surgical method, patients were divided into the SOT group (n=74 cases, undergoing supraclavicular open thyroidectomy) and the TGET group (n=86 cases, undergoing transaxillary gasless endoscopic thyroidectomy). Data were analyzed using SPSS 26.0 statistical software. Measurement data conforming to a normal distribution were expressed as (±s) and analyzed by independent samples t test or repeated measures analysis of variance. Categorical data were analyzed by χ² test or Fisher’s exact test. P<0.05 was considered statistically significant.

The operation time, postoperative extubation time, and hospital stay in the TGET group were longer than those in the SOT group, and the intraoperative blood loss and postoperative drainage volume were greater in the TGET group than in the SOT group (P<0.05). However, there was no significant difference in the number of dissected central lymph nodes between the two groups (P>0.05). The visual analog scale (VAS) scores at all postoperative time points in the TGET group were lower than those in the SOT group (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). At 3 months postoperatively, the Patient and Observer Scar Assessment Scale (POSAS) scores and the symptom domain scores of the Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QoL) in the TGET group were lower than those in the SOT group, while the psychological and social function domain scores of THYCA-QoL in the TGET group were higher than those in the SOT group (P<0.05).

TGET and SOT are comparable in terms of tumor radicality and surgical safety in the treatment of PTMC. However, TGET has significant advantages in reducing postoperative pain, improving satisfaction with neck appearance, and enhancing quality of life in patients.