MOLECULAR AND CLINICAL ASPECTS OF VIDEO-ASSISTED THORACOSCOPIC SURGERY FOR PERIPHERAL LUNG TUMORS

Abstract

The article examines the molecular and clinical features of video-assisted thoracoscopic surgery for peripheral lung tumors. VATS has become well established in the treatment of early-stage non-small cell lung cancer: the method allows anatomical resections to be performed through a low-trauma approach while maintaining the required oncological radicality. The epidemiological features of peripheral lung tumors are considered, including their more frequent detection at early stages due to the expansion of low-dose CT screening programs. The advantages of VATS over thoracotomy are analyzed separately: lower intraoperative blood loss, less pronounced postoperative pain, shorter hospitalization, and faster patient recovery. Modern types of anatomical resections are also discussed, including lobectomy, segmentectomy, sublobar resections, and wedge resections. Their role in small peripheral tumors less than 2 cm in diameter is shown. Methods of intraoperative navigation and localization of peripheral lesions are described, including CT-guided navigation, dye marking, hook wire placement, microcoils, and electromagnetic navigation bronchoscopy. Accurate localization of small and non-palpable nodules makes VATS resections safer: it reduces the probability of conversion and makes it possible to preserve a larger volume of functioning lung tissue. The molecular aspects of modern lung cancer therapy are considered separately, including the pathological response after neoadjuvant immunotherapy and the importance of targeted removal of the residual tumor focus. The presented data show that further development of VATS will be associated with the introduction of 3D modeling, fluorescence navigation, robot-assisted systems, and more precise selection of surgical tactics for each patient. Video-assisted thoracoscopic surgery remains one of the main areas of minimally invasive cardiothoracic surgery in the treatment of peripheral lung tumors.