Accounting for surgical interventions, their comparative analysis, comparability of the obtained data are impossible without using in clinical and research work a single adequate classification of operations for malignant lung tumors. From our point of view, of all the many classifications proposed by a number of authors, the most complete, reflecting the current state of lung surgery, terminology-based classification is proposed staff MNIOI them . Doubt is perhaps the term “typical operation”, which implies surgery without a mediastinal lymphadenectomy— “typical” in volume for lung cancer and resection of extrapulmonary anatomical structures and organs of the chest cavity. Since the need to remove the lymph nodes of the mediastinum at various stages of lung cancer still continues to be debated in the literature and there are different opinions on this issue, we consider it more justified to call such operations “simple”. It is also difficult to agree with the authors that the combined operations include surgical interventions in which resection of the adjacent lung lobe is performed. Such operations should be considered as variants of various resections of the lungs and their combinations.

Classifications did not reflect anatomical resections of the lungs with plastic elements of intrapulmonary vessels and lobar bronchi. Considering the fact that such surgical interventions cannot be attributed to combined operations, we consider it expedient to separate them in the group of anatomical pulmonary resections. And finally the last. Speaking about the nature of operations in cancer of the lung, along with their division into radical, palliative and trial, it seems appropriate to allocate more diagnostic thoracotomy. Although these surgical interventions do not belong to the category of treatment, but rather are an element of the diagnosis of lung cancer, they seem methodically justified to mention them, especially since practitioners often identify the terms “trial” and “diagnostic” thoracotomy.

Thus , classification with the specified additions and changes is offered to the reader. A. Scope of surgery I. Pneumonectomy
 
 
 Ii. Lung resection:

1) anatomical: a) lobectomy and its variants b) lobectomy with resection and plasty of lobar bronchi and intrapulmonary vessels c) segmentectomy 2) non-anatomical: a) wedge-shaped b) planar c) precision

Iii. Tracheal and large bronchus resection (without removal of lung tissue) IV. Endoscopic surgery and photodynamic therapy

1) removal of the tumor (electro-laser) 2) recanalization of the trachea and large bronchi B. Operational option I. Simple operation
 
 Ii. Extended surgery (mediastinal lymphadenectomy) III. Combined operation (resection of the adjacent organ) B. Nature of the operation I. Radical
 
 
 
 Ii.Palliative

Iii. Trial thoracotomy IV. Diagnostic thoracotomy

Lung cancer, like other malignant neoplasms, is a complex pathological process, the causes and mechanism of development of which are still not well understood. Even at the present level of knowledge it is impossible to give an exhaustive definition of the essence of tumor growth, as a biological process. There is no doubt that changes in the state of the whole homeostasis of the patient’s body play an important role in the occurrence and development of a tumor, we can take into account and actively influence on them only in the most general terms. It is practically impossible to assess the role of the relationship between local and general factors in the process of “sanagenesis” after the removal of a tumor. In addition, modern diagnostic methods do not give full confidence in the absence of “hidden” dissemination of the tumor process. Therefore, the radicalism of the operation is always conditional and can only be determined by the long-term results of treatment.

Speaking of radical advanced combined operations for lung cancer, we refer to them those surgical interventions in which, following the basic principles of ablastics and antiablasty, it is possible, within healthy tissues, to remove the organs and tissues affected by the tumor, in the absence of symptoms at the time of discharge from the clinic distant metastasis. We consider surgical interventions, in the course of which the complete removal of the tumor is not possible, or operations that are performed in violation of the principles of ablastics and anti-plastics, as well as when signs of generalization of the tumor process are detected at the time of surgery or in the postoperative period. Such a separation is very relative, often subjective, but justified, apparently, from a methodological point of view.