ArticleFrontiers in surgery2026
Ventilation SPECT/CT-guided air leak management: improving precision in a long-standing surgical challenge.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Objectives: Prolonged air leak (PAL) remains a significant surgical challenge after pulmonary resections and secondary spontaneous pneumothorax. Ventilation single-photon emission computed tomography combined with computed tomography (vSPECT/CT) has emerged as a promising tool for air leak localization. This study evaluates the impact of preoperative vSPECT/CT on surgical management of PAL. Methods: This single-center study compared a prospectively enrolled vSPECT/CT cohort (February 2021-December 2025) with retrospective historical controls (January 2015-January 2021). Propensity score matching generated two matched groups: with and without vSPECT/CT. Primary outcome was vSPECT/CT accuracy in detecting air leaks; secondary outcomes included chest tube duration, persistent PAL, reoperation rates, and hospital stay. Wilcoxon signed-rank and McNemar tests were used for comparisons. Results: A total of 122 patients were included (52 vSPECT/CT; 70 non-vSPECT/CT). vSPECT/CT showed a 95.3% concordance with intraoperative air leak localization. After matching, 86 patients (43 per group) were analyzed. The vSPECT/CT group had shorter chest tube duration (median 2 vs. 4 days; Conclusion: In this prospectively enrolled cohort, preoperative vSPECT/CT reliably localizes PAL, enabling focused surgical intervention and supporting more efficient postoperative recovery. Its use is associated with shorter chest tube duration and hospital stay, highlighting its value as a preoperative tool in the management of PAL.
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