The predictive significance of inflammatory parameters for postoperative complications in patients undergoing videothoracoscopic pulmonary resection for lung cancer.

Video-assisted thoracoscopic surgery (VATS) has become a preferred approach for lung resection due to its ability to reduce thoracotomy-related complications and improve patient comfort. Nevertheless, significant morbidity and even mortality may still occur. Recent evidence suggests that inflammation-based indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and lymphocyte-to-monocyte ratio (LMR), may serve as useful predictors of adverse outcomes. This study aimed to evaluate the predictive significance of these markers obtained during the preoperative and postoperative periods in patients undergoing VATS pulmonary resections. We retrospectively reviewed the records of patients who underwent VATS lobectomy or segmentectomy between January 2018 and December 2023. NLR, PLR, SII, and LMR were calculated from blood samples obtained preoperatively and on postoperative days 1 and 2. Receiver operating characteristic (ROC) analysis was used to determine optimal cut-off values, and patients were stratified into high and low groups accordingly. Associations between these groups and major complications were analyzed using Pearson's chi-square or Fisher's exact test. Among 359 patients (32.0% female; mean age, 65.5 ± 10.5 years), major postoperative complications occurred in 75 (20.9%) patients. Significant predictors included elevated postoperative NLR (day 1: p < 0.001; day 2: p = 0.009), elevated postoperative PLR (day 1: p = 0.03), elevated postoperative SII (day 1: p = 0.002; day 2: p = 0.01), and reduced preoperative (p = 0.002) and postoperative day 2 LMR (p = 0.001). Inflammatory indices derived from routine hemograms are simple, cost-effective, and reliable predictors of postoperative complications in patients undergoing VATS pulmonary resection for lung cancer. These findings underscore the potential value of incorporating perioperative inflammatory markers into risk stratification and clinical decision-making.