目的 探讨自制新型拉钩在锁骨下入路腔镜甲状腺手术中的安全性与可行性。 方法 回顾性分析赣南医科大学第一附属医院甲状腺疝外科2023年1月至2025年4月行单侧甲状腺乳头状癌手术期间180例资料，其中57例使用新型免充气拉钩行免充气甲状腺手术（锁骨下组），50例行充气型胸乳入路甲状腺手术（胸乳组），73例行传统开放型甲状腺手术（开放组），比较3组患者的手术相关指标、术后并发症发生率以及术后切口满意度的差异。 结果 与开放组相比，锁骨下组的患者年龄更小［（40.3 ± 9.4）岁vs. （44.8 ± 9.4）岁，P < 0.05］，手术时间更长［（81.68 ± 12.08）min vs. （73.01 ± 10.04）min，P < 0.05］。然而，锁骨下组术后第1天的疼痛评分较低［（2.28 ± 0.92）分vs. （4.19 ± 1.35）分，P < 0.05］，并且患者对术后切口的满意度更高。与胸乳组相比，锁骨下组的患者年龄较大［（40.3 ± 9.4）岁vs. （34.9 ± 8.2）岁，P < 0.05］，手术时间较短［（81.68 ± 12.08）min vs. （98.18 ± 15.14）min， P ＜ 0.05］。此外，锁骨下组的患者术后第1天疼痛评分较低［（2.28 ± 0.92）分vs. （3.12 ± 1.02）分，P < 0.05］，术后总引流量更少［80（70，100）mL vs. 120（100，150）mL，P < 0.05］。两组患者在切口满意度方面未见显著差异。3组在淋巴结清扫数量、术中出血量、术后第1天白细胞计数、甲状旁腺激素、钙离子浓度、术后并发症等方面差异无统计学意义（P > 0.05）。 结论 新型免充气拉钩在经锁骨下入路甲状腺腔镜手术中能够有效维持手术所需要的空间，具有较高的手术安全性，与传统开放手术和胸乳入路腔镜手术相比，锁骨下入路腔镜甲状腺手术疗效确切，且具有良好的美容效果。

Objective To evaluate the safety and feasibility of a novel self-made retractor in subclavian approach endoscopic thyroid surgery. Methods A retrospective analysis was conducted on 180 cases of unilateral papillary thyroid carcinoma surgery performed at the Thyroid Hernia Surgery Department of the First Affiliated Hospital of South Gannan Medical University from January 2023 to April 2025. Among these， 57 cases underwent non-inflated thyroid surgery using the novel non-inflated retractor （subclavian group）， 50 underwent pneumatic transsternal thyroid surgery （transsternal group）， and 73 underwent traditional open thyroid surgery （open group）. Differences in surgical indicators， postoperative complication rates， and postoperative incision satisfaction were compared among the three groups. Results Compared with the open group， patients in the subclavian group were younger ［（40.3 ± 9.4） years vs. （44.8 ± 9.4） years， P < 0.05］ and underwent longer surgery duration ［（81.68 ± 12.08） min vs. （73.01 ± 10.04） min， P < 0.05］. However， the subclavian group exhibited lower postoperative pain scores on the first day ［（2.28 ± 0.92） points vs. （4.19 ± 1.35） points， P < 0.05］ and higher patient satisfaction with postoperative incisions. Compared with the thoracic-mammary group， patients in the subclavian group were older ［（40.3 ± 9.4） years vs. （34.9 ± 8.2） years， P < 0.05］ and had shorter operative times ［（81.68 ± 12.08） min vs. （98.18 ± 15.14） min， P < 0.05］. Additionally， patients in the subclavicular group exhibited lower postoperative pain scores on day 1 ［（2.28 ± 0.92） points vs. （3.12 ± 1.02） points， P < 0.05］ and lower total postoperative drainage volume ［80 （70， 100） mL vs. 120 （100， 150） mL， P < 0.05］. No significant differences were observed between groups in terms of incision satisfaction. There were no statistically significant differences among the three groups in terms of the number of lymph nodes removed， intraoperative blood loss， white blood cell count on postoperative day 1， parathyroid hormone， calcium ion concentration， or postoperative complications（P > 0.05）. Conclusion The novel non-inflatable retractor effectively maintains the necessary surgical space during subclavicular approach thyroid endoscopic surgery， offering high surgical safety. Compared to traditional open surgery and trans-sternal endoscopic approaches， subclavicular endoscopic thyroid surgery demonstrates reliable therapeutic efficacy and excellent cosmetic outcomes.