![]() Hernandez-Vaquero D, Vigil-Escalera C, Pérez-Méndez I, Gutiérrez A, Avanzas P, Wei Y et al (2021) Survival after thoracoscopic surgery or open lobectomy: systematic review and meta-analysis. Stat Sci 25(1):1–21Īustin PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Stuart EA (2010) Matching methods for causal inference: a review and a look forward. Health Serv Outcomes Res Method 2:169–188 Rubin DB (2001) Using propensity scores to help design observational studies: application to the tobacco litigation. Kanda Y (2013) Investigation of the freely-available easy-to-use software “EZR” (Easy R) for medical statistics. Molnar TF, Benko I, Szanto Z, Nagy A, Horvath OP (2008) Complications after ultrasonic lung parenchyma biopsy: a strong note for caution. Nomori H, Abe M, Sugimura H, Takegawa Y, Oka S, Takeshi A (2014) Triple-layer sealing with absorptive mesh and fibrin glue is effective in preventing air leakage after segmentectomy: results from experiments and clinical study. Mayor JM, Lazarus DR, Casal RF, Omer S, Preventza O, Simpson K et al (2018) Air leak management program with digital drainage reduces length of stay after lobectomy. Stolz AJ, Schützner J, Lischke R, Simonek J, Pafko P (2005) Predictors of prolonged air leak following pulmonary lobectomy. Kent MS, Hartwig MG, Vallières E, Abbas AE, Cerfolio RJ, Dylewski MR et al (2021) Pulmonary open, robotic and thoracoscopic lobectomy (PORTaL) study: an analysis of 5721 cases. Our findings suggest that using the ultrasonic scalpel with fibrin glue plus polyglycolic acid sheet on parenchymal stumps could be used for the prevention of prolonged air leaks without being significantly inferior to the Endo stapler. Multiple logistic regression analysis using the presence or absence of prolonged air leaks as an outcome also showed no significant association between the use of the ultrasonic scalpel and the onset of prolonged air leak. After propensity score matching, no significant difference in the incidence of prolonged air leak between the automatic suture device group and the ultrasonic scalpel group (14.5% vs 19.3%, p = 0.535) was found. The emphysematous changes were extracted as a factor involved in the development of PAL. ![]() Prolonged air leaks occurred in 62 (19.3%) of all patients. The primary endpoint was the difference in the incidence of prolonged air leaks between 83 patients in the Endo stapler group and the ultrasonic scalpel group after confounding adjustment by propensity score matching. A case series analysis was conducted on 322 patients who underwent thoracoscopic surgery at our hospital. In this study, we analyzed the incidence of prolonged air leaks caused by Endo staplers or ultrasonic scalpels through propensity score matching. Postoperative pulmonary fistula is thought to arise from the site of staple-on-staple or pleural defect site that occurs during pulmonary parenchymal dissection by Endo stapler or ultrasonic scalpel, that is, interlobar or intersegmental formation. Prolonged air leaks are typical postoperative complications of thoracoscopic surgery for lung cancer.
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