Gasless endoscopic thyroidectomy for papillary thyroid microcarcinoma: safety and feasibility.

OBJECTIVE: To evaluate the comparative effectiveness of gasless endoscopic thyroidectomy (GET) versus conventional open thyroidectomy (COT) in the management of papillary thyroid microcarcinoma (PTMC). METHODS: A retrospective study of 150 PTMC cases was conducted, comparing patients treated with COT (COT group, n=70) to those undergoing GET (GET group, n=80). Key outcomes, including operating time (OT), hospital length of stay (HLOS), intraoperative blood loss (IBL), postoperative drainage volume, central lymph node dissection count, efficacy, postoperative complications, pain intensity, thyroid hormone levels, inflammatory cytokines, and cosmetic satisfaction, were compared between the groups. RESULTS: The GET group demonstrated significantly longer OT and greater postoperative drainage, therapeutic efficacy, and aesthetic satisfaction compared to the COT group(all P<0.05). However, the GET group showed lower IBL, pain intensity, and complication rates (all P<0.05). Additionally, variations in thyroid hormones and inflammatory cytokines were less pronounced in the GET group (all P<0.05). There were no significant differences in HLOS or the number of central neck lymph nodes dissected between the two groups (both P<0.05). CONCLUSION: GET surgery is a safe and feasible option for PTMC. It offers advantages such as better thyroid function preservation, reduced invasiveness and physiological stress, superior cosmetic outcomes, and less postoperative pain, supporting its clinical adoption.