Objective:To compare the surgical outcomes between scarless endoscopic thyroidectomy-lateral neck dissection (SET-LND) and open LND for papillary thyroid cancer (PTC) with lymph node metastasis and to share the experience in the prevention and treatment of lymphatic leakage after LND.Methods:Totally 90 PTC patients (25 males) who underwent LND in the Second Affiliated Hospital of Zhejiang University School of Medicine from Jan. 2021 to Aug. 2022 were retrospectively enrolled, with an average age of (28.06±4.89) years. They were divided into the SET-LND group ( n=50) and the open LND group ( n=40). The intraoperative blood loss, operation time, drainage volume on the first and the second days, postoperative lymphatic leakage, tumor (T), and node (N) were observed. The categorical variable data were compared between groups by χ 2 test, and the continuous variable data confirming normal distribution were compared between groups by independent sample t-test. Results:The operation time of the SET-LND group was (284.00±74.65) min, significantly longer than that of the open LND group (145.38±43.26) min ( t=-10.42, P<0.001). The intraoperative blood loss ( t=-1.309, P=0.194), postoperative hospital stay ( t=-0.136, P=0.892), drainage volume on the first day ( t=-1.074, P=0.286), and drainage volume on the second day ( t=-1.595, P=0.114), postoperative lymphatic leakage ( χ2=0.001, P=0.989), T ( t=0.367, P=0.714), N ( t=-1.614, P=0.110) were not significantly different between the two groups. Conclusion:Two surgical methods of LND have similar therapeutic effects and no significant difference was observed in the incidence of postoperative lymphatic leakage between the two groups.