Saving Lives in Thoracic Surgery: Balancing Oncological Radicality and Functional Preservation, Transitioning from Standard Pneumonectomy to Targeted Sublobar Resection

Simple Summary This manuscript provides a detailed analysis of the advancements in thoracic surgery. It traces the journey from the standard pneumonectomy to the precise approach of sublobar resections. The manuscript emphasizes the emergence and acceptance of advanced techniques such as robotic-assisted surgery. It also highlights the pivotal role of preserving organ functionality while ensuring oncological radicality, which is especially important when treating early-stage lung cancer. Through a comprehensive review of contemporary surgical methods and their clinical outcomes, this paper explains the delicate balance that modern thoracic surgeons must achieve between aggressive cancer removal and preserving the quality of life. It thereby contributes to the ongoing refinement of the field.Abstract This review chronicles the evolution of thoracic surgical interventions, from the standardized pneumonectomy to the precise approach of sublobar resections. It discusses the emergence and acceptance of minimally invasive and robot-assisted surgical techniques, highlighting their impact on improving outcomes beyond cancer and their influence on the surgical management of early-stage lung cancer. Evaluating historical developments alongside present methodologies, this review underscores the critical need for meticulous surgical planning and execution to optimize both oncological radicality and functional preservation. This evolution portrayed not only technical advancements but also a shift in the clinical approach towards tailored, organ-preserving methodologies, culminating in a contemporary framework promoting sublobar resections as the standard for specific patient profiles, signifying a new era of precision in thoracic surgery.