Objective:

To explore the safety, feasibility, and clinical value of CT-guided microwave ablation (MWA) combined with immediate uniportal video-assisted thoracoscopic surgery (Uni-VATS) in treating multiple pulmonary ground-glass nodules (GGNs), highlighting its significance in improving treatment options.

Key Findings:

• 31 patients (7 males, 24 females; mean age 59.3 ± 9.5 years) underwent the combined treatment.
• 78 lesions were treated: 32 with MWA and 46 with surgical resection.
• Mean nodule size for ablated lesions was 7.4 mm; for resected lesions, it was 12.2 mm.
• Postoperative complications occurred in one patient (specify types), resolving with symptomatic treatment.
• Technical success rate and clinical efficacy of MWA were 100%, with no severe complications or procedure-related mortality.
• No local recurrence or metastatic progression observed during follow-up.

Interpretation:

The combined approach of CT-guided MWA followed by Uni-VATS is safe and feasible, potentially offering an alternative treatment for patients unable to tolerate simultaneous removal of multiple nodules, with implications for future research.

Limitations:

• Retrospective nature of the study limits generalizability and may introduce biases.
• Small sample size may not represent broader patient populations.
• Short follow-up duration may not capture long-term outcomes.

Conclusion:

This preliminary experience suggests that the combined approach may enhance treatment options for patients with multiple GGNs, particularly those with compromised lung function, emphasizing the importance of these findings in patient care.