For papillary thyroid cancer, unilateral lobectomy with lymphatic dissection of zone 6 is an option for young patients. We found that the postoperative lymph node positivity rate in group 6 was around 60%, which is consistent with most of the foreign literature. It is not yet fully universal in China. For patients with high-grade factors: age >40 years, local invasion (trachea, muscles, nerves), contralateral mass also found, and more lymph node metastases in zone 6 bilaterally, total thyroidectomy should be performed. The probability that the contralateral side is also found to be cancerous after surgery is about 30% in our experience. Treatment of the recurrent laryngeal nerve: If the invasion of the recurrent laryngeal nerve can be stripped, it should be stripped as much as possible. If it cannot be preserved, it can be resected and pulled together for anastomosis, or reconstructed with anastomosis of the collateral branch of the hypoglossal nerve. Preservation of the paramedian glands: entirely dependent on empirical naked eye preservation, meticulous operation, surgical technique is very important