Talking about the precise treatment of “early stage” lung cancer patients With the development of medical technology and improvement of living standard, people are more and more concerned about their own health. Especially in recent years, with the gradual deterioration of the environment, people are aware of the harmful effects of air pollution, including hazy weather, smoking and kitchen fumes, which are all important factors triggering lung cancer. In the face of continuous air pollution and concerns about their own health, more and more people have been found to have lung nodules during medical checkups, and many have even reached the level of talking about nodules. The development of imaging techniques and the widespread use of low-dose spiral CT have greatly increased the detection rate of small nodules of unknown nature in the lung. However, it is difficult to give a clear conclusion for most of the small nodules smaller than 25px in the lung with ordinary CT technology, and the diagnosis report is often “right upper lung nodule, benign possible/malignant not excluded, please follow up”, which makes patients feel anxious and confused, and the diagnosis cannot be confirmed even with high-end PET-CT examination. Since 2010, our hospital has developed a unique 1024 scan technology for small lung nodules, which can help distinguish the fine structure of lung tissue, clearly display the morphological characteristics of small lung nodules, evaluate the nodule’s edge and infiltration, and accurately determine the nature of lung nodules, with an accuracy rate of more than 95%. 1024 scan specifically uses the latest 256-row ultra-high resolution CT for data acquisition and 3D reconstruction of small lung nodules. The pixel size of its image is 250/1024=0.24mm, which is many times smaller than the pixel size of conventional CT scan of 500/512=0.98mm, greatly improving the spatial resolution of the image and helping to differentially diagnose various types of pulmonary nodules (especially pulmonary ground glass nodules) and guide subsequent treatment. The International Society for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society jointly classify lung adenocarcinoma into pre-infiltrative lesions (including atypical adenomatous hyperplasia and carcinoma in situ), microinfiltrative adenocarcinoma, and invasive adenocarcinoma. The progression of lung cancer is mostly from atypical adenomatous hyperplasia → carcinoma in situ → microinvasive adenocarcinoma → infiltrative adenocarcinoma. The latest clinical data confirm that the majority of primary lung cancers below 25px with mainly ground glass lesions are carcinoma in situ and microinvasive lung cancer, which are both “inert” growth tumors, i.e., they take a long time to multiply, grow slowly, and rarely develop lymph nodes and distant metastases. These two types of lung cancers are “inert” growth tumors, i.e. they have a long multiplication time, grow slowly and rarely show lymph nodes and distant metastases, which we call “early stage” lung cancer, i.e. they are much earlier than what we call early stage lung cancer, and their long-term survival rate after surgery can reach 100%. How should we treat such “early stage” lung cancer? At present, the method of lobectomy + mediastinal lymph node dissection is still commonly adopted by most hospitals to treat early stage lung cancer. However, for microscopic lesions less than 25 px, removing an entire lobe of lung is a big loss for patients. In some patients, due to the decrease of respiratory reserve function after lung resection, there is no obvious discomfort at rest, but once physical activity increases, symptoms of pulmonary insufficiency such as shortness of breath, chest tightness and cough will appear to varying degrees, and the quality of life is obviously affected. The lung is an important respiratory organ, responsible for absorbing oxygen and expelling carbon dioxide, and it cannot be further regenerated after lung tissue is removed. With the aging of society’s population, many patients often have combined cardiopulmonary and vascular diseases, and such patients often have difficulty tolerating lobectomy. With the development of modern thoracoscopic techniques and medical imaging technology, minimally invasive precision lung segment resection surgery has emerged. This technique involves precise anatomical localization of lung nodules under preoperative CT guidance, and intraoperative thoracoscopic excision of precise lung segments at the lesion sites of early-stage microscopic lung cancer, along with local lymph node sampling or mediastinal lymph node dissection. The human body has a total of 5 lobes in the left and right lungs, which can be subdivided into 18 smaller lung segments, just like small branches growing out of a large tree trunk. Precise segmental lung resection is as effective as conventional lobectomy for early stage microscopic lung cancer lesions, and it can also preserve the patient’s lung function as much as possible and reduce surgical complications, which is truly minimally invasive. The principle of lung cancer surgery is “to remove the tumor to the maximum extent and preserve the lung function to the maximum extent”. Based on this treatment principle, we adopt the most advanced “precise diagnosis + precise treatment” model for “early and early stage” lung cancer through multidisciplinary collaboration, with the aim of screening early stage microscopic lung cancer in lung nodules and eliminating the surgical concerns of lung cancer patients. The aim is to screen for early stage microscopic lung cancer in lung nodules and eliminate surgical concerns for lung cancer patients. Specifically, we use 1024 CT scans for accurate diagnosis, combined with preoperative CT-guided lung nodule puncture for precise localization, and thoracoscopic minimally invasive sublobectomy (including wedge resection and anatomical segmental lung resection) during surgery. This enables complete removal of early microscopic cancerous nodules while preserving more healthy lung tissue for the patient. With this approach, we have performed more than five hundred cases of resection of cancerous lung nodules in recent years, with a 100% success rate and survival rate, and no significant complications. More and more early-stage lung cancers in situ and microinfiltrates are being detected and surgically removed in a timely manner, completely curing the patient’s disease while preserving more lung function for him or her and minimizing the damage to respiratory function. This treatment modality not only reduces the risk of surgery and facilitates the patient’s early recovery after surgery, but also preserves more lung function reserve for the patient’s postoperative activity endurance.