Division of the inferior pulmonary ligament during upper lobectomy does not improve postoperative pulmonary function: a systematic review and meta-analysis of observational studies and randomized controlled trials.
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Abstract
Background: Some surgeons routinely divide the inferior pulmonary ligament (IPL) during upper lobectomy. Nevertheless, the evidence remains inconclusive regarding whether dividing the IPL improves the postoperative pulmonary. This systematic review and meta-analysis aimed to assess the effects of inferior pulmonary ligament division (IPLD) during upper lobectomy.
Methods: Literature comparing IPLD and inferior pulmonary ligament preservation (IPLP) was identified and screened electronically from multiple electronic databases (data up to Nov 24. 2024). Postoperative changes in lung volume, bronchial angle, and drainage time (chest tube removed time), incidence of dead space, and postoperative pneumonia were assessed using Review Manager 5.4.1.
Results: 9 studies were identified, including two randomized controlled trials and seven retrospective case-control studies involving 1,612 patients. The present study demonstrated that: (1) IPLD may not improve dead space and lung volume after upper lobectomy. (2) IPLD significantly increased bronchial angle change after upper lobectomy on the left side while showing a tendency to increase bronchial angle change on the right side (3) IPLD did not have a statistically significant effect on postoperative drainage time and also did not reduce postoperative pneumonia.
Conclusion: IPLD for pulmonary function protection is unnecessary in upper lobectomy.
期刊介绍：
World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics.
Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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