To compare the clinical efficacy, safety, postoperative inflammatory stress response, aesthetic effect, and swallowing function between transaxillary non-inflatable endoscopic thyroidectomy (GTET) and open thyroidectomy for papillary thyroid microcarcinoma (PTMC).

The clinical data of 158 patients with newly diagnosed PTMC from January 2023 to September 2025 were retrospectively analyzed. The patients were divided into the endoscopic group (GTET, n=71) and the open group (traditional open thyroidectomy via the clavicle, n=87) based on the different surgical methods. The incidence of postoperative complications and other count data were analyzed using the χ² test; the perioperative related indicators and serum inflammatory factor levels before and after surgery that met the normal distribution were analyzed using the independent sample t test.

The operation time of the endoscopic group was longer than that of the open group, while the intraoperative blood loss, postoperative drainage volume, and hospital stay were lower in the endoscopic group (P<0.001); there were no statistically significant differences in the number of central lymph node dissections, positive lymph node detection rate, and total incidence of postoperative complications between the two groups (P>0.05); on the 3rd day after surgery, the levels of C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α) in the endoscopic group were lower than those in the open group (P<0.001); at 3 months after surgery, the Vancouver Scar Scale (VSS) score and swallowing disorder index (SIS-10) score of the endoscopic group were lower than those of the open group (P<0.001).

GTET can achieve similar short-term oncological clearance effects as open surgery in strictly selected PTMC patients; although the operation time is prolonged, it has advantages in reducing intraoperative bleeding, alleviating acute inflammatory stress response, and improving short-term cosmetic and swallowing functions.