Overview of thoracic surgery in France
Seance of wednesday 05 november 2025 (Progrès et Innovations en Chirurgie Thoracique)
DOI number : 10.26299/rkxh-dn20/emem.2025.45.01
Abstract
In 2024, thoracic surgery in France is primarily focused on the curative treatment of lung cancer, accounting for 40% of all procedures. Minimally invasive techniques, such as video-assisted thoracoscopic surgery (VATS, 49%) and robot-assisted thoracic surgery (RATS, 26%), are now predominant. Lobectomy remains the most common procedure (71%), while pneumonectomy has become rare (2%). Segmentectomy, on the rise (21%), is mainly used for early-stage cancers (32%), supported by 3D planning that enhances oncological precision and reduces complications. RATS has emerged as the reference technique for conservative resections, provided there is sufficient access.
The national screening program “Impulsion,” launched in 2025, aims to detect more cancers at an early stage (IA), where surgery offers the best 5-year survival rates (75-90%). Currently, over 50% of lung cancers are diagnosed at a metastatic stage. Organized screening could increase the volume of surgical interventions by 20-30% by 2030.
Reference surgical programs include lung transplantation (323 transplants in 2024, or 4.8 per million inhabitants), limited by the rate of opposition to organ donation (37%). Teams are developing solutions such as donation after circulatory death and ex-vivo lung perfusion. Finally, thromboendarterectomy for chronic thromboembolic pulmonary hypertension is increasing but is performed by only one team in France.
The national screening program “Impulsion,” launched in 2025, aims to detect more cancers at an early stage (IA), where surgery offers the best 5-year survival rates (75-90%). Currently, over 50% of lung cancers are diagnosed at a metastatic stage. Organized screening could increase the volume of surgical interventions by 20-30% by 2030.
Reference surgical programs include lung transplantation (323 transplants in 2024, or 4.8 per million inhabitants), limited by the rate of opposition to organ donation (37%). Teams are developing solutions such as donation after circulatory death and ex-vivo lung perfusion. Finally, thromboendarterectomy for chronic thromboembolic pulmonary hypertension is increasing but is performed by only one team in France.