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On the very severe fissureless cases the management procedure had been done pulmonary vein → bronchus → pulmonary artery. Mobilization of "fissure first, hilum last" and/or "hilum first, fissure last" techniques should be performed for VATS fissureless lobectomy.In the present study, influences of pleural adhesions on thoracoscopic lung surgeries were investigated. A total of 666 consecutive patients who had undergone thoracoscopic surgeries for lung malignant tumors were retrospectively analyzed. Pleural adhesions were present intraoper