Objective:To investigate the safety and feasibility of endoscopic thyroidectomy by gasless trans subclavian approach (ETGTA) in treatment of papillary thyroid carcinoma (PTC) .Methods:The clinical data of 148 patients with PTC radical operation admitted to the Department of Thyroid and Breast Surgery, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from Jul. 2020 to May. 2022 were retrospectively analyzed. They were divided into subclavian approach group (53 cases) and modified miccoli group (95 cases) according to different surgical approaches. The operation time, intraoperative bleeding volume, postoperative drainage flow, postoperative drainage days, postoperative hospital stay, postoperative complications and cosmetic satisfaction were recorded in the 2 groups. Statistical software was used to analyze the results, including t test, Mann-Whitney U test, χ2 test, etc. P<0.05 was considered statistically significant. Results:There were no significant differences in age, sex ratio, maximum diameter, stage, tumor lesion or surgical method between the 2 groups ( P>0.05). The postoperative drainage days increased in the subclavian group than in the modified miccoli group (4.57±2.45 vs. 2.98±1.07) ( P<0.01), but there was no statistical difference in operation time, intraoperative blood loss, postoperative drainage, or postoperative hospital stay between the two groups ( P>0.05). The incidence of swallowing discomfort at 1 month [5.6% (3/53) vs. 18.9% (18/95), P=0.04] and 3 months [0% (0/53) vs. 7.4% (7/95) , P=0.04], anterior cervical area tightness or stiffness at 1 month [0% (0/53) vs. 11.6% (11/95), P=0.01] and 3 months [0% (0/53) vs. 8.4% (8/95), P=0.03] were less than that of the modified miccoli group, and the difference was statistically significant (4.1±0.7 vs. 2.4±0.8) ( P<0.01), and the cosmetic satisfaction of the subclavian approach was higher than that of the modified miccoli group ( P<0.01). There was no significant difference in postoperative temporary recurrent laryngeal nerve injury, postoperative 3d neck pain, postoperative hand-foot numbness or postoperative hematoma between the two groups (all P>0.05) . Conclusion:The radical resection of papillary thyroid carcinoma without inflatable subclavicular approach is safe and feasible, with few postoperative complications and better cosmetic effect, which is worth popularizing.