ArticleThe Annals of thoracic surgery2018
Grading of Emphysema Is Indispensable for Predicting Prolonged Air Leak After Lung Lobectomy.
Article in The Annals of thoracic surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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24 citing papers in PubMed, 37 citations in OpenAlex.
- Article
- Advancing minimally invasive thoracic surgery: comparative insights into uniportal and multiportal robotic approaches for non-small cell lung cancer.General thoracic and cardiovascular surgery · 2026Article
- From Alveolar Injury to Precision Perioperative Care: Integrating Molecular Biomarkers and Technology-Enabled Strategies for Prolonged Air Leak After Lung Resection.Mediators of inflammation · 2026Review
- Significance of staple height on air leak after wedge resection for pulmonary malignant tumor.Journal of thoracic disease · 2025Article
- CT-based emphysema score is associated with prolonged air leak after lung resection: a retrospective cohort study.Journal of thoracic disease · 2025Article
- Artificial Intelligence as a Diagnostic Tool in Preoperative Surgical Planning for Early Non-Small Cell Lung Cancer: A Single-Center Experience.Journal of clinical medicine · 2025Article
- Predictors of intraoperative and postoperative air leakage in anatomical pulmonary resection.Surgery today · 2025Article
- Clinical impact of surgical approaches on early-phase postoperative air leakage.Scientific reports · 2025Observational
- Using A Surgical Risk Predictor to Estimate Percutaneous Cryoablation Adverse Event Risk: A Single Center Comparative Analysis.Journal of the American College of Radiology : JACR · 2025Article
- Data-driven prediction of prolonged air leak after video-assisted thoracoscopic surgery for lung cancer: Development and validation of machine-learning-based models using real-world data through the ePath system.Learning health systems · 2025Article
- Significance of measuring the severity of emphysema, in combination with spirometry, on the risk evaluation of patients undergoing major lung resection for cancer†.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- A New Functional Threshold for Minimally Invasive Lobectomy.Annals of surgery · 2024Article
- Risk factor analysis and predictive model development for air leakage after thoracoscopic pulmonary wedge resection.Journal of thoracic disease · 2024Article
- Intrinsic pulmonary sealing, its mechanisms and impact on validity and translational value of lung sealant studies: a pooled analysis of animal studies.Journal of thoracic disease · 2023Article
- The clinical effectiveness of staple line reinforcement with different matrix used in surgery.Frontiers in bioengineering and biotechnology · 2023Review
- CT-defined visual emphysema in smokers with normal spirometry: association with prolonged air leak and other respiratory complications after lobectomy for lung cancer.European radiology · 2022Article
- A risk model for prolonged air leak after lobectomy using the National Clinical Database in Japan.Surgery today · 2022Article
- Predictive factors and economic impact of prolonged air leak after pulmonary resection.General thoracic and cardiovascular surgery · 2022Article
- Preoperative variables for predicting prolonged air leak following pulmonary resection.Journal of thoracic disease · 2019Article
- Prolonged air leak after pulmonary lobectomy.Journal of thoracic disease · 2019Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to assess the utility of quantitative computed tomography-based grading of emphysema for predicting prolonged air leak after thoracoscopic lobectomy.
methodsA consecutive series of 284 patients undergoing thoracoscopic lobectomy for lung cancer was retrospectively reviewed. Prolonged air leak was defined as air leaks lasting 7 days or longer. The grade of emphysema (emphysema index) was defined by the proportion of the emphysematous lung volume (less than -910 HU) to the total lung volume (-600 to -1,024 HU) by a computer-assisted histogram analysis of whole-lung computed tomography scans.
resultsThe mean length of chest tube drainage was 1.5 days. Fifteen patients (5.3%) presented with prolonged air leak. According to a receiver-operating characteristics curve analysis, the emphysema index was the best predictor of prolonged air leak, with an area under the curve of 0.85 (95% confidence interval: 0.73 to 0.98). An emphysema index of 35% or greater was the best cutoff value for predicting prolonged air leak, with a negative predictive value of 0.99. The emphysema index was the only significant predictor for the length of postoperative chest tube drainage among conventional variables, including the pulmonary function and resected lobe, in both univariate and multivariate analyses. Prolonged air leak resulted in an increased duration of hospitalization (p < 0.001) and was frequently accompanied by pneumonia or empyema (p < 0.001).
conclusionsThe grade of emphysema on computed tomography scan is the best predictor of prolonged air leak that adversely influences early postoperative outcomes. We must take new measures against prolonged air leak in quantitative computed tomography-based high-risk patients.
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