目的：比较免充气腋径路腔镜与传统开放甲状腺手术的临床效果。方法：回顾性分析2015年8月至2020年7月瑞金医院卢湾分院普外科行单侧甲状腺全切除术的病人资料，按照手术方式分为两组，96例免充气腋径路腔镜单侧甲状腺手术(腔镜组)和232例传统开放单侧甲状腺手术(开放组)。比较两组手术相关指标、术后恢复相关指标及术后并发症发生率。结果： 腔镜组手术时间显著长于开放组[(168±23) min比(95±18) min，P=0.022]，术中喉返神经识别率两组差异无统计学意义（100.0%比99.1%，P=0.138），上、下甲状旁腺识别率腔镜组显著高于开放组（98.0%比97.0%；95.8%比99.1%，P=0.003、0.028）。术后首日引流量腔镜组显著高于开放组[(42±22) mL比(25±10) mL，P=0.006]，术后住院天数长于开放组[(2.8±0.6) d比(1.8±1.2) d，P=0.016]，住院费用两组差异无统计学意义[(13 186±1 015)元比(12 632±1 456)元，P=0.365]，总体并发症发生率两组差异无统计学意义(10.4%比9.1%，P=0.126)。 结论：免充气腋径路腔镜甲状腺手术安全可行，切口美观，但其手术手术时间和住院时间较长。

Objective To compare the clinical efficacy between air-free trans-axillary laparoscopic thyroidectomy and open thyroidectomy. Methods A retrospective analysis was performed on the data of both 96 patients who underwent air-free trans-axillary laparoscopic thyroidectomy (laparoscopic group) and 232 patients who underwent open thyroidectomy (open group) from August 2015 to July 2020. Comparative analysis were performed on operative data, the postoperative data of recovery and complications between two groups. Results The operative time in laparoscopic group was longer significantly than that in open group [(168±23) min vs. (95±18) min, P=0.022]. There was no significantly difference in the rate of recognition of recurrent laryngeal nerve between two groups (100.0% vs. 99.1%, P=0.138). The rate of recognition of both superior (98.0% vs. 97.0%, P=0.003) and inferior parathyroid glands (95.8% vs. 99.1%, P=0.028) in laparoscopic group was higher significantly than those in open group. The amount of drain of the first day after operation in laparoscopic group was more significantly than that in open group[(42±22) mL vs. (25±10) mL, P=0.006]. The postoperative length of hospital stay in laparoscopic group was longer significantly [(2.8±0.6) d vs. (1.8±1.2) d, P=0.016]. The cost of hospital stay was (13 186±1 015) yuan vs. (12 632±1 456) yuan （P=0.365） and the rate of postoperative complication was 10.4% vs. 9.1%（P=0.126）, which all showed no significant difference between two groups. Conclusions Air-free trans-axillary laparoscopic thyroidectomy could be feasible and safe, and have better appearance. However, both operative time and hospital stay were longer.