Résection pulmonaire infra-lobaire

Sublobar lung resection is a growing procedure in thoracic surgery. Two major randomized trials have recently demonstrated the favorable short- and long-term results of this parenchymal-sparing surgery, compared with lobectomy, in patients operated on for early-stage IA peripheral non-small-cell lung cancer (NSCLC). With the announced expansion of screening programmes, a new surgical era is opening up: Sublobar resection is a complex and demanding surgical procedure, with its own surgical anatomy and specific operative techniques. It relies on the development of minimally invasive surgery, 3D modelling and image-assisted techniques, as well as advances in enhanced recovery, to offer accurate, safe and personalized surgery. This “surgical de-escalation” requires a measured approach to surgical indication, compliance with strict carcinological quality criteria and, more broadly, support for the surgical community as it gains experience. Only then will sublobar resection become the cornerstone of early-stage NSCLC treatment, as part of a strong multidisciplinary consensus, combining functional preservation and improved quality of life with optimal oncological benefit.