Abstract: Objective To investigate the prognostic effect of gasless transaxillary endoscopic surgery combined with Chaihu Sanjie Formula on thyroid cancer. Methods A total of 95 patients with thyroid cancer who received endoscopic surgery from April 2023 to March 2025 were selected after 1∶1 propensity score matching. According to the different surgical methods and postoperative adjuvant treatments, the patients were divided into Group A （gas-insufflation endoscopic surgery via areola + Western medicine treatment, 31 cases）, Group B （gasless transaxillary endoscopic surgery + Western medicine treatment, 30 cases）, and Group C （gasless transaxillary endoscopic surgery + Western medicine treatment + Chaihu Sanjie Formula treatment, 35 cases）. Results All postoperative recovery indicators in the three groups showed statistical differences （P<0.05）; the time to first postoperative meal, the time to first postoperative ambulation, the time to drainage tube removal, the duration of hoarseness, the duration of drinking water cough, and the length of hospital stay were shorter in Group B and Group C than in Group A （P<0.05）; the time to drainage tube removal, the duration of hoarseness, the duration of drinking water cough, and the length of hospital stay were shorter in Group C than in Group B （P<0.05）, while the remaining indicators showed no statistical differences （P>0.05）. The postoperative complication rates in Group B and Group C were lower than that in Group A （P<0.05）, while there was no statistical difference between Group B and Group C （P>0.05）. The visual analogue scale pain scores at 6 h, 24 h, 48 h and 72 h after operation in the three groups showed statistical differences （P<0.05）, in which the scores of Group B and Group C were lower than those of Group A （P<0.05）, and the score of Group C was lower than that of Group B （P<0.05）. The levels of C-reactive protein, interleukin-6, thyroglobulin, thyroglobulin antibody, and thyroid peroxidase antibody in the three groups before operation showed no statistical difference （P>0.05）. The levels of inflammatory indicators in the three groups showed a downward trend at 3 d, 7 d, and 1 month after operation. The levels of inflammatory indicators in Group B and Group C were lower than those in Group A （P<0.05）, and those in Group C were lower than those in Group B （P<0.05）. There were no statistical differences in progression-free survival and overall survival among the three groups （P>0.05）. Conclusion Compared with conventional gas-insufflation endoscopic surgery via areola, gasless transaxillary endoscopic surgery for thyroid cancer patients can reduce surgical trauma and inflammatory stimulation, decrease complications, relieve pain, and achieve comparable prognostic effects; combined treatment with Chaihu Sanjie Formula does not affect the prognostic effect of tumor radical resection, but can further reduce inflammatory response and the degree of pain, accelerating postoperative recovery.

Key words: Gasless transaxillary endoscopic surgery, Chaihu Sanjie Formula, Thyroid cancer, Prognostic effect