TITLE:
Gasless Trans-Subclavian Endoscopic Thyroidectomy versus Conventional Open Thyroidectomy for Unilateral Papillary Thyroid Carcinoma: A Narrative Review
AUTHORS:
Lei Tang, Chuanchang Yin
KEYWORDS:
Papillary Thyroid Carcinoma, Endoscopic Thyroidectomy, Open Thyroidectomy, Trans-Subclavian Approach, Gasless Thyroidectomy, Quality of Life
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.8,
August
5,
2026
ABSTRACT: Unilateral papillary thyroid carcinoma (PTC) is often treated by lobectomy, sometimes together with central compartment lymph-node dissection when clinically indicated. Conventional open thyroidectomy (COT) remains the standard operation because it offers direct exposure and can be applied across a wide range of clinical situations. Its visible neck scar and postoperative cervical discomfort, however, matter to some patients. Endoscopic thyroidectomy (ET) moves the incision away from the anterior neck, but the term covers several distinct access routes whose results are not necessarily interchangeable. This narrative review examines ET in comparison with COT for unilateral PTC and focuses on gasless endoscopic thyroidectomy through the trans-subclavian approach (GETTSA). PubMed and official publisher websites were searched on June 22, 2026. Evidence specific to GETTSA remains limited, although recent retrospective comparisons and one randomized trial against the transaxillary route have added useful data. In carefully selected patients with unilateral cN0 disease or limited central-compartment involvement, short-term complication and nodal outcomes appear broadly similar to those reported after COT. The clearest advantage is concealment of the neck scar and the associated improvement in cosmetic satisfaction. GETTSA generally requires more operating time than open surgery, while differences in blood loss, drainage, length of stay, and transient hypoparathyroidism are inconsistent across studies. Direct comparisons with COT also suggest better scar-related and swallowing-related patient-reported outcomes, but they do not demonstrate oncologic superiority or long-term non-inferiority. On current evidence, GETTSA is best regarded as an option for selected patients in experienced centers, not as a replacement for open thyroidectomy.