Objective: Тo analyze short-term outcomes of anatomical lung resections using video-assisted thoracoscopic surgery (VATS) and thoracotomy approaches. Materials and methods: Our retrospective study included 530 patients who underwent surgery for various lung diseases in the thoracic surgery unit of City Multidisciplinary Hospital No. 2 (Saint Petersburg, Russian Federation) between 2014 and 2021. The patients were grouped based on the surgical approach: group 1 for patients who underwent VATS (n=378), group 2 for patients who underwent thoracotomy (n=120), and group 3 for patients who underwent conversion from VATS to thoracotomy (n=32). Results: Tumor size, paranodal and peribronchial changes were unfavorable prognostic factors for conversion from VATS to thoracotomy (odds ratio [OR]=1.032, CI: 1.013-1.051, P