Evidence map›Paper›PMID 41353423›Full record

SynthesisEuropean journal of medical research2025

Recommendations for the standardization and management of prolonged air leaks in lung surgery.

Francesco Zaraca, Marco Damiano Pipitone, Florian Augustin, Amr Abdellateef, Marcelo Jiménez, Andreas Kirschbaum, Calvin S H Ng, Dania Nachira, Isabelle Opitz, Clarissa Uslenghi and 5 more

Abstract readSystematic Review
In one paragraph

Synthesis in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Endoluminal approaches to postoperative air leaks.Journal of thoracic disease · 2026
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Francesco ZaracaDepartment of Vascular and Thoracic Surgery, Regional Hospital, Bolzano, Italy.
Marco Damiano Pipitone *Department of Vascular and Thoracic Surgery, Regional Hospital, Bolzano, Italy.
Florian Augustin *Department of Visceral, Transplant, and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Amr Abdellateef *Department of Cardiothoracic Surgery, Mansoura University Hospital, Mansoura, Egypt.
Marcelo Jiménez *Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.
Andreas Kirschbaum *Department of Visceral, Thoracic and Vascular Surgery, University of Marburg, Marburg, Germany.
Calvin S H Ng *The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China.
Dania Nachira *Department of General Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Isabelle Opitz *Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
Clarissa Uslenghi *Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435-20141 Milan (IT), Milan, Italy.
Marco LucchiDivision of Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
Roberto CrisciSchool of Medicine, University of L'Aquila, L'Aquila AQ, Italy.
Reinhold PerkmannDepartment of Vascular and Thoracic Surgery, Regional Hospital, Bolzano, Italy.
Lorenzo SpaggiariDepartment of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435-20141 Milan (IT), Milan, Italy.
Luca BertolacciniDepartment of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435-20141 Milan (IT), Milan, Italy. luca.bertolaccini@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProlonged air leaks (PAL) are a common postoperative complication following lung surgery, associated with increased morbidity, extended hospital stays, and heightened healthcare costs. The incidence of air leaks ranges from 20 to 33%, with PAL occurring in 6%-26% of cases. Management strategies for PAL remain inconsistent, highlighting the need for standardized guidelines to address this issue. This study employed the GRADE approach to develop consensus-based recommendations for detecting and managing post-lung surgery PAL.

methodsA task force of 18 thoracic surgeons, including a methodologist, conducted a systematic literature review focusing on 14 critical clinical questions. Recommendations were developed based on evidence from meta-analyses, randomized controlled trials, and observational studies, and graded according to the quality of evidence and the strength of the recommendation.

resultsThirty-five studies were included in the final analysis. The consensus highlighted the lack of standardization in defining PAL and emphasized the need for personalized management based on clinical context. Key recommendations included the use of reinforced staples, parenchymal sutures, and sealants in high-risk patients, the preference for digital drainage systems, and the management of confirmed PALs with strategies such as chemical pleurodesis and surgical exploration.

conclusionsThe consensus underscores the importance of a multidisciplinary approach in managing PAL, the need for standardizing definitions, and the ongoing requirement for evidence-based guidelines to improve patient outcomes. Future research should focus on addressing the limitations identified in this study.

Indexed as

Postoperative ComplicationsPractice Guidelines as TopicPulmonary Surgical ProceduresHumansExpert panelGRADELung CancerProlonged air leaksRecommendations

Identifiers

PMID41353423
PMCPMC12797480

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.