Lung cancer is a malignant tumor with the highest morbidity and mortality both in China and even in the world.Accurate diagnosis and treatment of this disease are crucial to improving the survival and quality of life of patients.Computed tomography （CT）-guided percutaneous lung puncture is an important method for the diagnosis and treatment of lung diseases，but heavily relies on doctors' professional skills and surgical experience in practices.The robot-assisted percutaneous surgery system integrates a series of emerging technologies to improve the accuracy and safety of percutaneous lung puncture，reduce the difficulty of operation，and reduce the occurrence of complications through puncture path planning，respiratory movement monitoring，robot-assisted positioning，etc.This technology has been increasingly used in clinical scenarios，such as lung biopsy，ablation，and preoperative localization for thoracoscopic surgery.In order to standardize the operating procedures of CT-guided percutaneous lung puncture for diagnosis，treatment and localization with the robot-assisted percutaneous surgery system and to summarize key points，Guangdong Association of Thoracic Diseases organized experts from various fields （thoracic surgery，respiratory medicine，oncology，interventional therapy，etc.） to develop this expert consensus.
To estimate the impact of adjuvant chemotherapy on survival in T2bN0M0 nonsmall cell lung cancer（NSCLC）patients.
Methods
The clinicopathological data of patients with stage T2bN0M0 NSCLC who underwent lobectomy and mediastinal lymph node dissection between 2010 and 2015 were retrospectively analyzed in the Surveillance，Epidemiology，and End Results（SEER）database.The risk factors were identified by Cox regression.Propensity score matching（PSM）analysis and Kaplan-Meier curves were used to compare the cancerspecific survival（CSS）and overall survival（OS）of T2bN0M0 NSCLC patients between the non-adjuvant chemotherapy and adjuvant chemotherapy groups.
Results
A total of 538 patients with completely resected stage T2bN0M0 NSCLC were enrolled in this study，including 285 males and 253 females，with a median age of 69（62-75）years.Patients with younger，grade III-IV were more likely to receive chemotherapy（P＜0.05）.In Cox regression，adjuvant chemotherapy was significantly associated with OS in completely resected stage T2N0M0 NSCLC（hazard ratio =0.52，95% confidence interval 0.36-0.74，P＜0.05）.In the total population，patients treated with adjuvant chemotherapy had a better OS than those not treated with adjuvant chemotherapy before and after PSM（P＜0.05）.In addition，adjuvant chemotherapy can bring a survival benefit for patients ＜70 years old，but does not improve OS for patients≥70 years old.Similarly，for poor-to-undifferentiated patients，adjuvant chemotherapy can improve the OS of patients，but for moderate-to-well differentiated patients，adjuvant chemotherapy cannot bring survival benefit.
Conclusion
Adjuvant chemotherapy contribute to a survival benefit in completely resected stage T2bN0M0 NSCLC patients，especially in patients ＜70 years and poor-to-undifferentiated NSCLC patients.Adjuvant chemotherapy should be considered in completely resected stage T2bN0M0 NSCLC patients.
To explore the effects of different surgical methods on chronic cough after lung surgery in patients with peripheral lung adenocarcinoma with maximum tumor diameter ≤2 cm.
Methods
Earlystage lung adenocarcinoma patients who underwent thoracoscopic surgery at the Department of Thoracic Surgery of Provincial Hospital of Anhui Medical University from January 2021 to December 2021 were retrospectively analysed and divided into lobectomy，segmentectomy and wedge groups according to the surgical methods to analyse the effects of lobectomy，segmentectomy and wedge resection on the chronic cough of early-stage lung adenocarcinoma patients in the postoperative period.Logistic regression analysis was used to analyse the risk factors of postoperative chronic cough in patients with early-stage lung adenocarcinoma.
Results
The maximum diameter of tumor in the lobectomy group were larger than that in the segmentectomy and wedge resection groups，and the difference was statistically significant（P＜0.001）.The lung lobe group had more thoracic adhesions than the lung segment and wedge groups（P=0.015）.Patients in the lung lobe group underwent more systematic lymph node dissection（P＜0.001），more upper mediastinal lymph node dissection（P＜0.001），and more subluxation lymph node dissection（P＜0.001） than patients in the lung segment group and wedge group.Patients in the lung lobe group had longer anesthesia time and postoperative banding time than those in the lung segment and wedge groups，with significant differences（P＜0.001，P＜0.001）.Univariate and multifactorial analyses revealed that the tumor was located in the upper lung lobe（P=0.002），lobectomy（P=0.047），systematic lymph node dissection（P＜0.001），upper mediastinal lymph node dissection（P＜0.001），and subglottic lymph node dissection were performed（P＜0.001），and the longer the duration of anesthesia and the duration of post-operative tube banding（P＜0.001，P=0.013） were independent risk influences for chronic cough after lung surgery in patients with early stage lung adenocarcinoma.
Conclusion
Early-stage lung adenocarcinoma patients who underwent lobectomy were more likely to develop postoperative chronic cough after lung surgery than early-stage lung adenocarcinoma patients who underwent sublobar lobectomy.In addition，when the tumor is located in the upper lobe of the lung，mediastinal lymph node dissection is performed，anesthesia time and postoperative time with tubes are long，more attention should be paid to prevent the occurrence of chronic cough after lung surgery after surgery.
To summarize the clinical data of bronchopleural fistula （BPF） patients，analyze the causes， and explore the treatment methods and efficacy.
Methods
From April 2021 to June 2024 in Department of Thoracic Surgery，Affiliated Zhongshan Hospital of Dalian Uninersity，6 patients with BPF after lung resection were treated with bronchoscopy （injection of polidocanol around the bronchial fistula） and surgical intervention after the failure of conservative treatment.
Results
Among the 6 patients，4 were males and 2 were females，aged 60 years on average；5 patients underwent right lower lobe resection；3 patients had a long history of smoking；1 patient had diabetes mellitus；3 patients had combined anemia and hypoproteinemia.The mean length of the bronchial stump was （0.8±0.4） cm.The median time to postoperative BPF was 71.5 days.One patient underwent thoracoscopic BPF repair.Five patients were treated with endoscopic injection of sclerosing agent，and one of them had R1 resection，failed endoscopic treatment，and was transferred to surgical repair，with a success rate of interventional therapy of 80%.After follow-up of 3 to 40 months，BPF was healed.
Conclusion
Combining a large amount of relevant research，our group found that BPF after lung resection is related to smoking，malnutrition，right lower lobe surgery，and R1 resection.Endoscopic sclerotherapy is effective，yet surgery remains the final treatment.
Lung nodules are a common chest imaging manifestation，which has received extensive attention from the clinic and society.In recent years， artificial intelligence （AI） technology based on computed tomography （CT） images has matured and has been widely applied in the classification of lung nodule detection，pathologic typing，malignancy degree and gene mutation prediction.The aim of this paper is to sort out and analyze the relevant studies of AI in the field of lung nodule diagnosis and treatment.
