Yu-Ding TsengKe-Cheng ChenJIN-SHING CHEN2022-10-172022-10-172010AL:10156267-201008-201202150018-201202150018-12-15https://scholars.lib.ntu.edu.tw/handle/123456789/623789Lung cancer is the leading cause of cancer death in Taiwan. Surgery provides the best chance for cure and long-term survival in early stage non-small cell lung cancer (NSCLC) patients. With the advent of minimally invasive surgical techniques and instruments, thoracoscopic surgery has emerged as a reasonable alternative for the diagnosis and treatment of NSCLC. The current review focuses on three perspectives of minimal invasive surgery for lung cancer. First, thoracoscopic lobectomy has increasingly gained acceptance and it is supported by evidence- based treatment guidelines as an alternative to open thoracotomy for managing early stage lung cancer. Second, sublobar resection has become an acceptable alternative to lobectomy in patients with a tumor size less than 2 cm or with poor cardiopulmonary reserve. Sublobar resection is associated with a lower complication rate and comparable long-term survival in select patients. Third, non-intubated thoracoscopic surgery under less invasive anesthetic approaches such as thoracic epidural anesthesia and proper sedation are feasible and safe, and are associated with less intubation- and ventilator-associated complications. In summary, a combination of minimally invasive technique, parenchyma-sparing pulmonary resection, and optimal anesthesia will make lung cancer surgery safer and allow more patients to become eligible for adjuvant chemotherapy, radiotherapy, or targeted therapy whenever indicated.enthoracic surgerythoracoscopylung cancerjournal article10.6323/JoCRP.2010.26.4.2