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
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 effec...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | World Journal of Surgical Oncology |
| Online Access: | https://doi.org/10.1186/s12957-025-03669-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832571616494616576 |
|---|---|
| author | Boyang Chen Weifeng Tang Junhai Chen Mingqiang Kang Jinbiao Xie Wu Wang Tianbao Yang Shijie Huang |
| author_facet | Boyang Chen Weifeng Tang Junhai Chen Mingqiang Kang Jinbiao Xie Wu Wang Tianbao Yang Shijie Huang |
| author_sort | Boyang Chen |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-d16471fbd66b4e84b38b91f294bb3586 |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-d16471fbd66b4e84b38b91f294bb35862025-02-02T12:27:34ZengBMCWorld Journal of Surgical Oncology1477-78192025-01-012311810.1186/s12957-025-03669-6Division 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 trialsBoyang Chen0Weifeng Tang1Junhai Chen2Mingqiang Kang3Jinbiao Xie4Wu Wang5Tianbao Yang6Shijie Huang7Department of Cardiothoracic Surgery, Affiliated Hospital of Putian UniversityDepartment of Esophageal Surgery, Department of Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical SchoolDepartment of Cardiothoracic Surgery, Affiliated Hospital of Putian UniversityDepartment of Cardiothoracic Surgery, Affiliated Hospital of Putian UniversityDepartment of Cardiothoracic Surgery, Affiliated Hospital of Putian UniversityDepartment of Cardiothoracic Surgery, Affiliated Hospital of Putian UniversityDepartment of Cardiothoracic Surgery, Affiliated Hospital of Putian UniversityDepartment of Cardiothoracic Surgery, Affiliated Hospital of Putian UniversityAbstract 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.https://doi.org/10.1186/s12957-025-03669-6 |
| spellingShingle | Boyang Chen Weifeng Tang Junhai Chen Mingqiang Kang Jinbiao Xie Wu Wang Tianbao Yang Shijie Huang 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 World Journal of Surgical Oncology |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://doi.org/10.1186/s12957-025-03669-6 |
| work_keys_str_mv | AT boyangchen divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials AT weifengtang divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials AT junhaichen divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials AT mingqiangkang divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials AT jinbiaoxie divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials AT wuwang divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials AT tianbaoyang divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials AT shijiehuang divisionoftheinferiorpulmonaryligamentduringupperlobectomydoesnotimprovepostoperativepulmonaryfunctionasystematicreviewandmetaanalysisofobservationalstudiesandrandomizedcontrolledtrials |