Clinical Research Directory

Inclusion Criteria: 1. Age 18 to 85 years at the time of enrollment. 2. Presence of multiple pulmonary nodules identified on chest computed tomography (CT). 3. At least one dominant pulmonary lesion meeting standard indications for thoracoscopic surgical resection based on radiologic assessment. 4. At least one additional pulmonary nodule for which complete surgical resection is considered undesirable due to lung parenchyma preservation concerns or procedural risk, and deemed suitable for robot-assisted CT-guided percutaneous intervention. 5. Determined by a multidisciplinary team (MDT) to be an appropriate candidate for the predefined hybrid treatment strategy. 6. Eligible for non-intubated video-assisted thoracoscopic surgery based on preoperative anesthetic evaluation (ASA physical status I-III). 7. Ability to understand the study procedures and provide written informed consent. Exclusion Criteria: 1. Pulmonary nodules located centrally or adjacent to major airways, major vessels, or the heart, where safe percutaneous intervention is not feasible. 2. Pure ground-glass nodules with a maximum diameter \< 6 mm, for which active surveillance is recommended. 3. Clinical evidence of N1/N2 lymph node involvement or distant metastasis. 4. Severe cardiopulmonary disease, interstitial lung disease, or other conditions that preclude thoracoscopic surgery or anesthesia. 5. Coagulation disorders or ongoing anticoagulation therapy that cannot be safely discontinued. 6. Pregnancy or breastfeeding. 7. Any condition that, in the opinion of the investigator, would make participation unsafe or interfere with study assessments.