Tumor–phrenic nerve spatial relationship and intraoperative traction-induced injury during mediastinal tumor resection: implications for real-time protective strategies

This study demonstrates that real-time, threshold-guided modulation of intraoperative mechanical and thermal stress can reduce phrenic nerve injury and enhance recovery, particularly in anatomically preserved but functionally vulnerable nerves. Rather than replacing surgical judgment, the proposed strategy provides a quantifiable, replicable adjunct for nerve preservation in technically challenging thoracic procedures.