ArticleJournal of thoracic disease2018
Pathophysiological mechanism of post-lobectomy air leaks.
Article in Journal of thoracic disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Construction and validation of a nomogram for predicting prolonged air leak after minimally invasive pulmonary resection.World journal of surgical oncology · 2022Trial
- Diaphragm-Directed Strategies for Prolonged Air Leak Prevention After Lung Resection: A Narrative Review of the Residual Pleural Space Paradigm.Journal of clinical medicine · 2026Review
- Endoluminal approaches to postoperative air leaks.Journal of thoracic disease · 2026Review
- Risk factor analysis and predictive model development for air leakage after thoracoscopic pulmonary wedge resection.Journal of thoracic disease · 2024Article
- Article
- A nomogram for preoperative prediction of prolonged air leak after pulmonary malignancy resection.Translational lung cancer research · 2021Article
- Minimizing the Risk of Aerosol Contamination During Elective Lung Resection Surgery.Annals of surgery · 2020Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAir leak post-lobectomy continues to remain a significant clinical problem, with upper lobectomy associated with higher air leak rates. This paper investigated the pathophysiological role of pleural stress in the development of post-lobectomy air leak.
methodsPreoperative characteristics and postoperative data from 367 consecutive video assisted thoracic surgery (VATS) lobectomy resections from one centre were collected prospectively between January 2014 and March 2017. Computer modelling of a lung model using finite element analysis (FEA) was used to calculate pleural stress in differing areas of the lung.
resultsAir leak following upper lobectomy was significantly higher than after middle or lower lobectomy (6.3% versus 2.5%, P=0.044), resulting in a significant six-day increase in mean hospital stay, P=0.004. The computer simulation model of the lung showed that an apical bullet shape was subject to eightyfold higher stress than the base of the lung model.
conclusionsAfter upper lobectomy, the bullet shape of the apex of the exposed lower lobe was associated with high pleural stress, and a reduction in mechanical support by the chest wall to the visceral pleura due to initial post-op lack of chest wall confluence. It is suggested that such higher stress in the lower lobe apex explains the higher parenchymal air leak post-upper lobectomy. The pleural stress model also accounts for the higher incidence of right-sided prolonged air leak post-resection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.