CT-guided transthoracic core-needle biopsy (CT-TTNB) is a minimally invasive procedure that plays a crucial role in diagnosing pulmonary nodules. With high diagnostic yield and low complication rates, CT-TTNB is favored over traditional surgical biopsies, providing accuracy in detecting both malignant and benign conditions. This literature review aims to present a comprehensive overview of CT-TTNB, focusing on its indications, procedural techniques, diagnostic yield, and safety considerations. Studies published between 2013 and 2024 were systematically reviewed from PubMed, Web of Science, Scopus, and Cochrane Library using the SANRA methodology. The results highlight that CT-TTNB has a diagnostic yield of 85–95% and sensitivity rates for detecting malignancies between 92 and 97%. Several factors, including nodule size, lesion depth, needle passes, and imaging techniques, influence diagnostic success. Complications such as pneumothorax and pulmonary hemorrhage were noted, with incidence rates varying from 12 to 45% for pneumothorax and 4 to 27% for hemorrhage. Preventative strategies and management algorithms are essential for minimizing and addressing these risks. In conclusion, CT-TTNB remains a reliable and effective method for diagnosing pulmonary nodules, particularly in peripheral lung lesions. Advancements such as PET/CT fusion imaging, AI-assisted biopsy planning, and robotic systems further enhance precision and safety. This review emphasizes the importance of careful patient selection and procedural planning to maximize outcomes while minimizing risks, ensuring that CT-TTNB continues to be an indispensable tool in pulmonary diagnostics.

Background and Objectives: Pulmonary resections are critical interventions for treating various lung pathologies, both benign and malignant. Understanding the impact of these surgeries on patients’ Quality of Life (QoL) is essential for optimizing care. This study aims to compare the Health-Related Quality of Life (HRQoL) and psychological well-being in patients who underwent pulmonary resections for benign versus malignant etiologies. Methods: A cross-sectional study was conducted involving 117 patients who underwent pulmonary resection between January 2022 and June 2023. Participants were divided into two groups: 51 patients with benign lung conditions and 66 with malignant lung tumors. HRQoL was assessed using the SF-36 and WHOQOL-BREF questionnaires. Anxiety and depression levels were evaluated using the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS-10). Patients were assessed pre- and post-intervention. Results: Patients with malignant etiologies were older (58.7 vs. 54.2 years) and had lower FEV1% predicted (79.1% vs. 82.5%) compared to the benign group. Malignant patients reported significantly lower scores in physical functioning (68.1 vs. 75.4), role-physical (65.0 vs. 72.3), and general health domains of the SF-36 (62.4 vs. 70.2). WHOQOL-BREF scores indicated a lower overall QoL in the malignant group, particularly in the physical health (65.3 vs. 72.1) and psychological domains (68.0 vs. 74.5). HADS scores revealed higher anxiety (9.1 vs. 7.2) and depression levels (8.5 vs. 6.8) among malignant patients. Correlation analyses showed strong associations between lower QoL scores and higher anxiety and depression levels. Conclusions: Pulmonary resections for malignant conditions are associated with a significant decline in HRQoL compared to benign conditions. Patients with malignant etiologies experience higher levels of anxiety and depression, emphasizing that clinicians should integrate specialized mental health services and tailored physical rehabilitation programs for patients undergoing pulmonary resections for malignant lung conditions to address their significantly reduced quality of life and increased psychological distress.

Background and Objectives: The benefit of lobe-specific lymph node dissection (LS-LND) in non-small cell lung cancer (NSCLC) remains debated, especially in early-stage disease. Previous reviews often included all stages, leaving a gap in focused evaluations of clinical stage IA–IB NSCLC. This systematic review, supplemented by our institutional experience, aimed to compare overall survival (OS), recurrence-free survival (RFS), and postoperative complications between LS-LND and systematic lymph node dissection (S-LND) in clinical stage IA–IB NSCLC. Methods: We retrospectively reviewed 24 patients treated at our institution (14 S-LND vs. 10 LS-LND). Data on patient demographics, operative details, OS, RFS, and postoperative complications were collected. Risk of bias was assessed using established methodological tools. A targeted literature search was conducted in PubMed, EMBASE, and Web of Science from inception to 14 April 2022. Only three articles (total n = 1101 patients) met inclusion criteria focusing on clinical stage IA–IB NSCLC who underwent curative-intent resection. Results: LS-LND demonstrated comparable or slightly improved 5-year OS (range: 69.7–96.7%) versus S-LND (64.9–92.0%), and similar or slightly higher RFS (66.0–95.6% in LS-LND vs. 60.8–88.8% in S-LND). In our cohort, the 5-year OS was 78.6% in S-LND vs. 80.0% in LS-LND, and the 5-year RFS was 71.4% vs. 70.0%, respectively. Postoperative complications such as arrhythmias were less frequent in LS-LND groups overall. Our data showed a low rate of pneumonia in S-LND compared to LS-LND (7.1% vs. 10.0%); however, arrhythmias accounted for 14.3% in S-LND vs. 10.0% in LS-LND). Conclusions: For clinical stage IA–IB NSCLC, LS-LND offers oncologic outcomes that are comparable to S-LND, with a potential for reduced postoperative complications. The findings from our institution align with these trends observed in the literature. While these results suggest potential advantages of lobe-specific approaches, definitive conclusions require further validation through larger, prospective randomized studies to confirm the clinical benefits of LS-LND in early-stage NSCLC.

Background/Objectives: CT-guided transthoracic core needle biopsy (CT-TTNB) is the standard technique for histological characterization of pulmonary lesions, yet it carries a 15–42% rate of pneumothorax and a 5–27% rate of alveolar hemorrhage. Accurate identification of modifiable and non-modifiable procedural determinants is essential for pre-procedural risk stratification, technique optimization, and post-procedural care. Methods: We conducted a single-centre retrospective cohort study of 240 consecutive CT-TTNB procedures performed between November 2023 and January 2025. The variables were extracted from medical records and PACS and entered into univariate and multivariate analysis models. Model performance was assessed by AUC-ROC, Nagelkerke R², and the Hosmer–Lemeshow test. Results: Pneumothorax occurred in 79 patients (32.9%), with chest tube drainage required in 14 (5.8%). Alveolar hemorrhage was identified in 49 patients (20.4%). Four independent predictors for pneumothorax were identified: needle–pleural angle (OR 0.837/1°; p < 0.001), pleura-to-lesion distance (OR 1.675/10 mm; p < 0.001), fissure traversal (OR 26.718; p = 0.003), and patient age (OR 1.076/year; p = 0.002); AUC-ROC 0.927. The alveolar hemorrhage model identified pleura-to-lesion distance (OR 1.768/10 mm; p < 0.001), RUL apical segment (OR 4.281; p < 0.001), and carcinomatous lymphangitis as protective factors (OR 0.359; p = 0.030); AUC-ROC 0.822. The needle–pleural angle was not independently associated with alveolar hemorrhage, confirming mechanistically distinct complication pathways. Conclusions: Needle–pleural angle is the dominant modifiable determinant of pneumothorax and pneumothorax-related complications. Optimizing the trajectory towards perpendicularity does not increase hemorrhage risk. These findings support the implementation of angle-based trajectory planning protocols and risk-stratified post-procedural monitoring.

Background: Pulmonary lobe resection is a common surgical intervention for various benign lung diseases, including tuberculosis (TB), bronchiectasis, and benign lung nodules. While immediate clinical outcomes are well documented, the impact on patients’ quality of life (QoL) remains less explored. This study aims to evaluate QoL before and after pulmonary lobe resection over a 6-month period among patients with benign lung diseases. Objectives: To assess and compare changes in QoL among patients undergoing pulmonary lobe resection for TB, bronchiectasis, and benign lung nodules, and to identify factors influencing QoL outcomes. Methods: This prospective study included 84 patients who underwent pulmonary lobe resection for benign lung diseases, divided into three groups: TB (n = 22), bronchiectasis (n = 31), and benign lung nodules (n = 31). QoL was assessed using the SF-36 and WHOQOL-BREF questionnaires preoperatively and at 6 months postoperatively. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS), and perceived stress was measured using the Perceived Stress Scale (PSS-10). Statistical analyses included paired t-tests, ANOVA, and Pearson’s correlation, with p-values < 0.05 considered significant. Results: At 6 months postoperatively, all groups showed significant improvements in physical and mental QoL scores (p < 0.05). The TB group exhibited the greatest improvement in physical health domains, while the bronchiectasis group showed significant enhancement in social functioning. Anxiety and depression scores decreased significantly in all groups, with the TB group showing the most substantial reduction (p < 0.01). Perceived stress levels also decreased across all groups. Comparisons revealed that the TB group had significantly higher QoL improvement compared to the other groups (p < 0.05). Conclusions: Pulmonary lobe resection for benign diseases significantly improves QoL over a 6-month period, particularly in patients with TB. The findings suggest that surgical intervention not only alleviates physical symptoms but also enhances psychological well-being. These results underscore the importance of considering QoL outcomes in the management of benign lung diseases requiring surgical intervention.