Journal of Cardiothoracic Surgery最新文献

{"title":"Awareness and perceptions of artificial intelligence among pulmonologists and thoracic surgeons: a national survey.","authors":"Gizem Özçıbık Işık, Neslihan Özçelik, Hasan Volkan Kara","doi":"10.1186/s13019-026-04672-y","DOIUrl":"10.1186/s13019-026-04672-y","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI), a set of algorithms that mimic human intelligence, is increasingly being used in the healthcare field.</p><p><strong>Objective: </strong>This study aims to evaluate the awareness, expectations, and concerns of pulmonologists and thoracic surgeons regarding AI, as well as to assess their level of adaptation to these technologies.</p><p><strong>Methods: </strong>A 23-item online survey was administered to specialists and residents in the fields of pulmonology and thoracic surgery between January and May 2025. Participation was voluntary, and informed consent was obtained from all respondents. Data were analyzed using SPSS version 27.0, with a p-value of < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Among the 302 participants, 65.6% were pulmonologists and 34.4% were thoracic surgeons. A total of 85.4% believed that AI will be actively used in clinical practice, and 67.5% believed that AI would reduce the need for physician workforce. However, 59.3% considered AI less successful than physicians in diagnosis, and 65.6% in treatment. In addition, 86.8% emphasized the need for legal regulations, and 58.3% expressed concerns about data privacy.</p><p><strong>Conclusions: </strong>Participants generally expressed a positive attitude toward AI, although they remained cautious due to ethical, legal, and technical concerns. Comprehensive regulations regarding education, legislation, and data security are needed to ensure the safe and effective integration of AI into clinical practice.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repair of a thoracic incisional hernia in a patient after elective abdominothoracic esophageal resection.","authors":"Felix Rühlmann, Andrew McIntyre, Jochen Gaedcke","doi":"10.1186/s13019-026-04661-1","DOIUrl":"10.1186/s13019-026-04661-1","url":null,"abstract":"<p><strong>Background: </strong>Herein, we report from a 70-year-old male patient being diagnosed with a thoracic intercostal incisional hernia who prior underwent abdominothoracic surgery due to carcinoma of esophagogastric junction. These hernias are very rare, therefore there exist no established techniques for surgical treatment.</p><p><strong>Case presentation: </strong>The patient has described a pain in the right-sided hemithorax and a bulge while coughing for several weeks. He had a long history of smoking. Clinical examination revealed an intercostal anterolateral hernia which was confirmed via radiological computed tomography (CT) scan with a defect size of 7.5 cm.</p><p><strong>Conclusions: </strong>Subfascial hernia mesh repair is feasible in thoracic incisional hernia and was well-tolerated by the patient. However, these hernias remain very rare therefore there are no common recommendations for standardized treatment. Future data should be collected centrally using registered data bank.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LncRNA GAS6-AS1 affects doxorubicin‑induced cardiomyocyte injury in H9c2 cells by regulating miR‑152‑3p: a cellular model relevant to heart failure.","authors":"Mi Li, Ning Lu, Luxi Yang, Jinping Wu","doi":"10.1186/s13019-026-04524-9","DOIUrl":"10.1186/s13019-026-04524-9","url":null,"abstract":"<p><strong>Objective: </strong>To explore the diagnostic significance of LncRNA GAS6-AS1 in chronic heart failure (CHF) and its molecular mechanism of influencing cardiomyocyte function through the regulation of miR-152-3p.</p><p><strong>Methods: </strong>This study incorporated 126 patients diagnosed with CHF and 124 healthy control subjects. The serum level of GAS6-AS1 was determined via RT-qPCR, and its diagnostic efficacy was assessed through ROC curve. A cell injury model was established by stimulating H9c2 cells with DOX. CCK-8, flow cytometry and RT-qPCR were used to analyze the effects of these on cell viability, apoptosis and inflammatory factors (TNF-α, IL-6, IL-1β). The targeting relationship between GAS6-AS1 and miR-152-3p was verified by DLR.</p><p><strong>Results: </strong>The expression of GAS6-AS1 in the serum of CHF patients was significantly downregulated. ROC analysis showed that the sensitivity of GAS6-AS1 in the diagnosis of CHF was 84.90%, the specificity was 77.40%, and the AUC was 0.888 (95% CI: 0.849-0.928). Overexpression of GAS6-AS1 could mitigate the reduction in cell viability and the elevation in apoptosis induced by DOX in H9c2 cells, and inhibit the expression of pro-inflammatory factors. GAS6-AS1 could directly bind to miR-152-3p. Overexpression of miR-152-3p could reverse the inhibitory effect of GAS6-AS1 on cell apoptosis and the release of inflammatory factors.</p><p><strong>Conclusion: </strong>GAS6-AS1 can act as a potential diagnostic biomarker for CHF. It might accomplish this by targeting and suppressing miR-152-3p, thus decreasing cardiomyocyte apoptosis and inflammatory reactions.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Evaluation of nursing performance during coronary artery bypass grafting surgeries using machine learning analysis of surgical videos: a multicenter retrospective study.","authors":"Qing Tang, Seidu A Richard, Shi Peng, Hong Qian, Jun Li, Haiya Wang","doi":"10.1186/s13019-026-04669-7","DOIUrl":"10.1186/s13019-026-04669-7","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The highly expressed lncRNA TRG-AS1 in serum specifically inhibits miR-139-5p, thereby promoting oxidative stress and inflammation in heart failure.","authors":"Ying Shi, Wenhua Wang, Chuanqing Weng, Xiangyang Zhang","doi":"10.1186/s13019-026-04629-1","DOIUrl":"https://doi.org/10.1186/s13019-026-04629-1","url":null,"abstract":"<p><strong>Objective: </strong>Patients with chronic heart failure (CHF) have a high mortality rate. The aim of this research is to examine the clinical value and molecular mechanisms of the lncRNA T cell receptor gamma chain-associated AS1 (TRG-AS1) in CHF.</p><p><strong>Methods: </strong>The TRG-AS1 expression in 116 CHF patients was assessed by qRT-PCR. The diagnostic and prognostic value of TRG-AS1 was evaluated through ROC and COX survival analysis. The correlation between TRG-AS1 and clinical parameters was examined using Pearson's correlation analysis. Cell growth and death were assessed using the CCK-8 assay and double-staining methods. ELISA was used to detect inflammatory factors. The DLR assay was used to verify the interaction between TRG-AS1, miR-139-5p, and RUNX1.</p><p><strong>Results: </strong>TRG-AS1 is upregulated in CHF (P < 0.0001) and is positively correlated with BNP (r = 0.500, P < 0.0001) and CRP levels (r = 0.398, P < 0.0001), while negatively correlated with LVEF (r=-0.605, P < 0.0001). TRG-AS1 is an risk factor for poor patient prognosis (HR = 3.043, 95%CI: 1.359-6.816, P = 0.007) and possesses good diagnostic value (AUC = 0.895, 95%CI: 0.852-0.938, Sensitivity: 84.5%, Specificity: 80.0%, P < 0.0001). Knocking out TRG-AS1 enhances cell proliferation, reduces apoptosis, alleviates oxidative stress, and inhibits the release of inflammatory factors by reducing the binding to miR-139-5p (P < 0.01).</p><p><strong>Conclusion: </strong>TRG-AS1 may serve as a new diagnostic biomarker for CHF. The TRG-AS1/miR-139-5p axis may represent a potential therapeutic target for CHF. Furthermore, RUNX1 has been preliminarily identified as a downstream target gene of this ceRNA.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A structured pre-procedural risk mitigation strategy for ultra-high-risk TAVR in a nonagenarian with extreme aortic valve calcification: a case report using a balloon-expandable valve and proactive ECMO backup.","authors":"Lang Hong, Zhaohui Liu, Xuehong Zhang, Chang Yao, Siping Peng","doi":"10.1186/s13019-026-04615-7","DOIUrl":"10.1186/s13019-026-04615-7","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) in nonagenarians with extensive aortic valve calcification is associated with a substantial risk of intraprocedural circulatory collapse.</p><p><strong>Case presentation: </strong>This case report describes a structured pre-procedural risk mitigation strategy integrating a balloon-expandable valve system and a pre-emptive, \"wet-prepared\" extracorporeal membrane oxygenation (ECMO) backup. A 97-year-old man with severe symptomatic aortic stenosis (peak velocity = 4.76 m/s; aortic valve calcium volume = 1178 mm³) underwent transfemoral TAVR using a structured approach incorporating precision imaging, careful device selection using a domestic Chinese balloon-expandable valve system (Prizvalve^® TAV23), proactive ECMO preparedness, and multidisciplinary team coordination. Immediately after valve deployment, the patient developed circulatory collapse (blood pressure = 40/20 mmHg). A predefined emergency protocol was promptly activated. Following chest compressions, vasopressor administration, and pacing optimization, spontaneous circulation was restored within minutes. Angiography confirmed stable valve positioning with satisfactory expansion. At 3-month follow-up, echocardiography demonstrated absence of paravalvular leakage and preserved left ventricular systolic function.</p><p><strong>Conclusions: </strong>This case demonstrates the feasibility of a structured, pre-procedural risk mitigation strategy for TAVR in an exceptionally high-risk patient. The approach enabled the management of intraprocedural circulatory collapse. In this setting, the balloon-expandable valve platform demonstrated procedural characteristics that were well suited for this complex anatomy.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive nomogram for abdominal aortic calcification risk: a multi-algorithm approach integrating demographic and clinical variables.","authors":"Yapeng Zhu, Wei Guo, Hongpeng Zhang","doi":"10.1186/s13019-026-04588-7","DOIUrl":"10.1186/s13019-026-04588-7","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic calcification (AAC), a significant predictor of cardiovascular events and mortality, lacks a simple predictive tool for early risk stratification. This study aimed to develop and validate a clinical nomogram for predicting AAC risk using accessible demographic, comorbidity, and lifestyle factors.</p><p><strong>Methods: </strong>Utilizing data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) cohort, AAC was assessed via dual-energy X-ray absorptiometry (DXA) using the Kauppila scoring system (score > 0 defined AAC). Participants were stratified into training (n = 2,198) and validation (n = 942) cohorts. The nomogram was developed through multi-algorithm consensus, incorporating predictors selected by three robust methodologies: Least Absolute Shrinkage and Selection Operator (LASSO) regression, the best subsets regression (BSR) method and the Boruta algorithm. Model performance was evaluated through ROC, calibration, and decision curve analysis (DCA) curves.</p><p><strong>Results: </strong>Five predictors-age, BMI, cardiovascular disease (CVD), hypertension, and smoking status-were identified. The nomogram demonstrated robust discrimination, with AUCs of 0.747 (95% CI: 0.724-0.770) and 0.700 (95% CI: 0.660-0.735) in training and validation cohorts, respectively. Calibration curves revealed strong agreement between predicted and observed probabilities. DCA curves confirmed clinical utility across risk thresholds.</p><p><strong>Conclusions: </strong>This validated nomogram provides a practical tool for AAC risk stratification using readily obtainable clinical parameters, enabling targeted interventions to mitigate calcification progression. Its integration into routine cardiovascular assessments may enhance preventive strategies in resource-limited settings.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-222-3p targeting MEGF9 exacerbates sepsis-induced myocardial injury.","authors":"Weiwei Dou, Zhenhua Wu, Xue Yu, Wei Wang, Wei Chen","doi":"10.1186/s13019-026-04641-5","DOIUrl":"10.1186/s13019-026-04641-5","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-induced myocardial injury (SIMI) commonly occurs as a complication of severe sepsis and septic shock. This research aims to explore the function of miR-222-3p inhibition in SIMI and its possible regulatory mechanisms.</p><p><strong>Methods: </strong>A rat SIMI model was established using the cecal ligation and puncture method. In vitro experiments were conducted using lipopolysaccharide (LPS) to induce myocardial injury in H9C2 cells. miR-222-3p and MEGF9 expression were determined using qRT-PCR. Myocardial injury, inflammatory response, and oxidative stress indicators were detected using the ELISA and biochemical colorimetric assays. Cell viability and apoptosis were assessed using the CCK-8 method and flow cytometry. The interaction between miR-222-3p and MEGF9 was verified through a luciferase reporter gene assay.</p><p><strong>Results: </strong>In the serum of rats with sepsis and LPS-induced H9C2 cells, miR-222-3p exhibited high expression, while MEGF9 was lowly expressed. Inhibition of miR-222-3p alleviated myocardial injury, inflammatory response, and oxidative stress in sepsis rats and LPS-induced cells, as evidenced by reduced CK-MB, cTnI, LDH, IL-6, IL-1β, TNF-α, and MDA level, and enhanced SOD activity. Inhibition of miR-222-3p increased LPS-induced cell viability and diminished apoptosis. miR-222-3p targeted MEGF9. Inhibiting MEGF9 expression could reverse the protective role of miR-222-3p suppression on LPS-induced myocardial injury.</p><p><strong>Conclusion: </strong>This study's results indicate that miR-222-3p exacerbates SIMI reactions by targeting and inhibiting MEGF9 expression. It is possible that miR-222-3p functions as a potential therapeutic target for SIMI.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanism study of miR-324-3p driving myocardial infarction progression through regulation of myocardial inflammation.","authors":"Hongxia Liu, Wenjing Zhu, Wenzheng Wang, Ruishuang Tang","doi":"10.1186/s13019-026-04497-9","DOIUrl":"10.1186/s13019-026-04497-9","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to analyze the expression of miR-324-3p in acute myocardial infarction (AMI), as well as its regulatory effects on inflammatory responses, oxidative stress, and cell viability in cardiomyocytes.</p><p><strong>Method: </strong>This study enrolled 77 AMI patients and 82 healthy controls. The serum miR-324-3p levels were detected using qRT-PCR, and their diagnostic efficacy was evaluated through ROC analysis. Then construct the H/R injury model to analyze the damage of inflammatory factors, oxidative stress, and cell viability to H9c2 cardiomyocytes. Through the combination of site prediction, luciferase reporter gene validation, and STAT3 gene rescue experiments, the critical role of STAT3 in the regulation of miR-324-3p was revealed.</p><p><strong>Results: </strong>In AMI patients, miR-324-3p is significantly upregulated and has high diagnostic value. Overexpression of miR-324-3p exacerbates H/R-induced inflammation, while its inhibition alleviates inflammation. Under H/R treatment, the expression of miR-324-3p increased while the expression of STAT3 decreased. Knocking down STAT3 can reverse the protective effect of the miR-324-3p inhibitor, further confirming the critical role of STAT3 in the miR-324-3p regulatory pathway.</p><p><strong>Conclusions: </strong>The abnormal elevation of miR-324-3p has a potential diagnostic value for AMI. miR-324-3p plays a significant role in H/R-injured cardiomyocytes by targeting and inhibiting the expression of STAT3.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of non-intubated spontaneous breathing video-assisted thoracoscopic surgery (NI-VATS) versus intubated general anesthesia (I-VATS) on the risk of postoperative venous thromboembolism.","authors":"Jia Ye, Dong Chen, Zhimiao Tang","doi":"10.1186/s13019-026-04598-5","DOIUrl":"https://doi.org/10.1186/s13019-026-04598-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;By preserving spontaneous breathing and avoiding mechanical ventilation, Non-intubated video-assisted thoracoscopic surgery may attenuate perioperative inflammatory responses and promote early mobilization, thereby influencing the risk of venous thromboembolism. However, whether the risk of postoperative venous thromboembolism differs between Non-intubated video-assisted thoracoscopic surgery and conventional Intubated video-assisted thoracoscopic surgery remains unclear due to a lack of definitive evidence. We hypothesized that patients undergoing Non-intubated video-assisted thoracoscopic surgery would have a lower risk of postoperative venous thromboembolism.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-center retrospective study was conducted. Patients with lung cancer who underwent video-assisted thoracoscopic lung surgery at the Department of Cardiothoracic Surgery, Jinhua Central Hospital between March 2025 and July 2025 were enrolled and, based on the anesthetic approach, divided into the Non-intubated video-assisted thoracoscopic surgery group (n = 25) and the Intubated video-assisted thoracoscopic surgery group (n = 30). The primary outcome was the risk of venous thromboembolism, as assessed by thrombotic complications, postoperative coagulation parameters, time to early postoperative ambulation, time to first flatus, and time to first defecation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No perioperative venous thromboembolic complications occurred in either group. Regarding coagulation parameters, the D-dimer level in the Non-intubated video-assisted thoracoscopic surgery group was 0.30 (0.04, 0.70) µg/L, which was significantly lower than 0.77 (0.34, 1.46) µg/L in the I-VATS group (P = 0.006). There were no statistically significant differences in prothrombin time (PT) or activated partial thromboplastin time (APTT) between the two groups (P &gt; 0.05). The time to early postoperative ambulation was significantly shorter in the Non-intubated video-assisted thoracoscopic surgery group [0 (0, 0) days] than in the Intubated video-assisted thoracoscopic surgery group [1 (1, 1) days] (P &lt; 0.001). The time to first flatus and defecation was 1 (1, 1) day in the Non-intubated video-assisted thoracoscopic surgery group, significantly shorter than 2 (2, 3) days in the Intubated video-assisted thoracoscopic surgery group (P &lt; 0.001). Furthermore, the Non-intubated video-assisted thoracoscopic surgery group exhibited a significantly attenuated elevation in the inflammatory marker (leukocyte count: 2.24 ± 0.39 × 10⁹/L) compared with the Intubated video-assisted thoracoscopic surgery group (5.82 ± 0.60 × 10⁹/L).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Non-intubated video-assisted thoracoscopic surgery may reduce the risk of venous thromboembolism through several mechanisms: maintaining negative intrathoracic pressure generated by spontaneous breathing, lowering the risk of elevated intra-abdominal pressure, and facilitating early mobili","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}