ArticleJournal of minimal access surgery2026
Feasibility and safety of video-assisted thoracic surgery after neoadjuvant chemoimmunotherapy in non-small cell lung cancer: A single-centre experience.
Article in Journal of minimal access surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionNeoadjuvant chemoimmunotherapy has emerged as a promising strategy in the multimodal treatment of locally advanced non-small cell lung cancer (NSCLC). However, concerns remain regarding its impact on surgical complexity and the feasibility of video-assisted thoracic surgery (VATS) in this setting. PATIENTS AND
methodsBetween April 2021 and August 2024, 17 patients who received neoadjuvant chemoimmunotherapy (PD-1 inhibitor plus chemotherapy) underwent lung resection. A significant proportion of cases (58.8%) were managed through VATS (primarily biportal approach), with no conversions to open surgery. The remaining patients underwent thoracotomy or Dartavelle incision due to anatomical complexity.
resultsThe mean operative time was 135 ± 25 min for VATS and 172.9 ± 30 min for open surgery ( P = 0.068). While hospital stay was similar between VATS (5.9 days) and open surgery (6.4 days) ( P = 0.449), intensive care unit stay was significantly shorter in the VATS group (0.5 vs. 1.3 days, P = 0.007). Significant tumour downstaging was observed in 88.2% of patients, with four achieving complete pathological response and three demonstrating a major pathological response ( P < 0.05). Post-operative complications were observed in 41.2% of patients, but no 90-day mortality occurred.
conclusionVATS appears to be a feasible and safe approach for selected NSCLC patients after neoadjuvant chemoimmunotherapy, demonstrating favourable short-term outcomes. These findings contribute to the growing evidence supporting minimally invasive surgery as a viable option in complex, locally advanced cases following immunotherapy.
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