目的

探讨ⅢA 期肺腺癌接受新辅助免疫+化疗、靶向治疗后的疗效评估，以及行胸腔镜微创手术的可行性和安全性。

方法

回顾性分析2024 年4 月在解放军总医院第一医学中心胸外科进行的1 例胸腔镜右肺中下叶切除术治疗经过新辅助化疗+免疫、靶向治疗后，病理缓解明确的IIIA 期肺腺癌患者临床资料。

结果

手术过程顺利，难度较大，手术时间150 min，出血量50 ml。 术后恢复顺利，无漏气、肺不张等相关并发症，术后恢复良好，5 d 出院。

结论

EGFR 敏感基因突变ⅢA期肺腺癌患者经过新辅助化疗+免疫、靶向治疗后，病理缓解明确，手术安全可行。

Objective

To evaluate the efficacy of neoadjuvant immunotherapy combined with chemotherapy and targeted therapy in patients with stage ⅢA lung adenocarcinoma， as well as the feasibility and safety of thoracoscopic minimally invasive surgery.

Methods

A retrospective analysis was conducted on a case of thoracoscopic right lower lobectomy performed in Apr. 2024 at the First Medical Center of the PLA General Hospital. The patient had stage ⅢA lung adenocarcinoma with confirmed pathological response following neoadjuvant chemotherapy， immunotherapy， and targeted therapy.

Results

The surgical procedure was successfully completed， albeit with considerable difficulty. The operation lasted 150 minutes with an estimated blood loss of 50 ml. Postoperative recovery was uneventful， with no complications such as air leakage or atelectasis. The patient was discharged in good condition on postoperative day 5.

Conclusion

Patients with stage ⅢA lung adenocarcinoma harboring EGFR-sensitive mutations demonstrated a clear pathological response following neoadjuvant chemotherapy combined with immunotherapy and targeted therapy. Thoracoscopic surgery is safe and feasible in this context.