Lung Fissural Integrity: It’s Written in the Genes

Garner, Justin; Desai, Sujal R.

doi:10.1164/rccm.202106-1526ed

Cited by 2 publications

(2 citation statements)

References 18 publications

(21 reference statements)

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“…Unlike the previous study performed by Attaar et al, we found that patients undergoing left-sided surgery were at higher risk of PAL compared with right-sided surgery. This might be due to the longer and hypoplastic oblique fissure of the left lung, resulting in greater damage to the pulmonary parenchyma during surgery [ 36 , 37 ]. Interestingly, we first found that prolonged operation duration was an independent risk factor for PAL.…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of a nomogram for predicting prolonged air leak after minimally invasive pulmonary resection

Xue

et al. 2022

World J Surg Onc

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Background Prolonged air leak (PAL) remains one of the most frequent postoperative complications after pulmonary resection. This study aimed to develop a predictive nomogram to estimate the risk of PAL for individual patients after minimally invasive pulmonary resection. Methods Patients who underwent minimally invasive pulmonary resection for either benign or malignant lung tumors between January 2020 and December 2021 were included. All eligible patients were randomly assigned to the training cohort or validation cohort at a 3:1 ratio. Univariate and multivariate logistic regression were performed to identify independent risk factors. All independent risk factors were incorporated to establish a predictive model and nomogram, and a web-based dynamic nomogram was then built based on the logistic regression model. Nomogram discrimination was assessed using the receiver operating characteristic (ROC) curve. The calibration power was evaluated using the Hosmer-Lemeshow test and calibration curves. The nomogram was also evaluated for clinical utility by the decision curve analysis (DCA). Results A total of 2213 patients were finally enrolled in this study, among whom, 341 cases (15.4%) were confirmed to have PAL. The following eight independent risk factors were identified through logistic regression: age, body mass index (BMI), smoking history, percentage of the predicted value for forced expiratory volume in 1 second (FEV1% predicted), surgical procedure, surgical range, operation side, operation duration. The area under the ROC curve (AUC) was 0.7315 [95% confidence interval (CI): 0.6979–0.7651] for the training cohort and 0.7325 (95% CI: 0.6743–0.7906) for the validation cohort. The P values of the Hosmer-Lemeshow test were 0.388 and 0.577 for the training and validation cohorts, respectively, with well-fitted calibration curves. The DCA demonstrated that the nomogram was clinically useful. An operation interface on a web page (https://lirongyangql.shinyapps.io/PAL_DynNom/) was built to improve the clinical utility of the nomogram. Conclusion The nomogram achieved good predictive performance for PAL after minimally invasive pulmonary resection. Patients at high risk of PAL could be identified using this nomogram, and thus some preventive measures could be adopted in advance.

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Section: Discussionmentioning

confidence: 99%

Construction and validation of a nomogram for predicting prolonged air leak after minimally invasive pulmonary resection

Xue

et al. 2022

World J Surg Onc

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“…Determining fissure integrity using quantitative CT, a surrogate for absent interlobar CV, is a key assessment prior to EBV therapy [67]. A fissural integrity score of > 95% predicts success whilst < 80% warrants referral for alternative procedures including surgery or investigational treatments such as vapour or coils -those with intermediate scores (i.e., 80-95% complete) are recommended to undergo a Chartis test [61,68].…”

Section: Predictors Of Responsementioning

confidence: 99%

Endobronchial treatment of severe asthma and severe emphysema with hyperinflation

Garner

Shah

2021

Current Opinion in Pulmonary Medicine

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Purpose of reviewThe field of interventional pulmonology has ushered in a wave of innovations for individuals with obstructive airways disease in whom established medical therapies have failed. Leading the charge are bronchial thermoplasty for severe refractory asthma and uni-directional valves for severe emphysema with hyperinflation: both have received regulatory approvals in the United Kingdom and United States. With the commissioning of these novel treatments comes new challenges relating to implementation, positioning within therapeutic algorithms, honing of patient selection, and establishing long-term safety and benefits beyond 5 years. Recent findingsThis review summarises the evidence for their safety and efficacy, predictors of therapeutic response, mechanism(s) of action and emerging data supporting the durability of outcomes out to at least ten years.

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Lung Fissural Integrity: It’s Written in the Genes

Cited by 2 publications

References 18 publications

Construction and validation of a nomogram for predicting prolonged air leak after minimally invasive pulmonary resection

Construction and validation of a nomogram for predicting prolonged air leak after minimally invasive pulmonary resection

Endobronchial treatment of severe asthma and severe emphysema with hyperinflation

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