This study is a single-center, cluster randomized controlled trial evaluating whether lung three-dimensional model-assisted preoperative consultation can improve shared decision-making in adult patients undergoing thoracoscopic anatomical lung resection.

Six attending thoracic surgeons will be randomized to provide either three-dimensional model-assisted consultation or usual preoperative consultation. Patients in the intervention group will receive consultation supported by a generic lung three-dimensional model and patient-specific three-dimensional reconstruction data generated from routine preoperative imaging. Patients in the control group will receive usual preoperative consultation according to current clinical practice.

The primary outcome is patient-perceived shared decision-making measured immediately after consultation using the 9-item Shared Decision-Making Questionnaire. Secondary outcomes include anxiety, disease- and surgery-related knowledge, communication satisfaction, health-related quality of life, decision regret, consultation duration, and postoperative outcomes within 30 days.

Inclusion Criteria:

1. Adults aged 18 years or older.
2. Scheduled to undergo elective thoracoscopic anatomical lung resection for suspected or confirmed lung tumors, defined as lobectomy or segmentectomy.
3. The planned operation and relevant alternatives can be reasonably discussed during preoperative consultation by the attending thoracic surgeon.
4. Clinically stable and able to participate in preoperative consultation.
5. Able to read, understand, and complete Chinese questionnaires independently or with neutral assistance from research staff.
6. Able and willing to provide written informed consent. -

Exclusion Criteria:

1. Emergency surgery.

2. Planned wedge resection only, pneumonectomy, extrapleural pneumonectomy, or non-thoracoscopic open surgery at recruitment.

3. Previous major ipsilateral thoracic surgery that substantially alters thoracic anatomy and may make the generic model misleading.

4. Known cognitive impairment, severe psychiatric disorder, severe visual impairment, severe hearing impairment, or language barrier that prevents effective participation in consultation or questionnaire completion.

5. Participation in another interventional study expected to affect preoperative anxiety, patient education, decision-making, or perioperative communication.

6. Any other condition judged by the investigators to make the patient unsuitable for this study.

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Due to the visible nature of the communication intervention, surgeons and participants cannot be blinded. Research staff responsible for questionnaire administration, clinical outcome extraction, and statistical analysis will be blinded to group allocation whenever feasible.