{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:46:16Z","timestamp":1791261976161,"version":"4.1.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,1,4]],"date-time":"2020-01-04T00:00:00Z","timestamp":1578096000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,4]],"date-time":"2020-01-04T00:00:00Z","timestamp":1578096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The necessity of the inferior pulmonary ligament (IPL) dissection after an upper lobectomy remains controversial. This meta-analysis aimed to evaluate whether this accessional procedure could reduce the postoperative complications and improve outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>PubMed, Embase, Ovid, Cochrane Library, CBM, and CNKI databases were searched for the relevant studies which compared the dissection with preservation of IPL during the upper lobectomy. The Review Manager 5.3 software was used for this meta-analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Three RCTs and five CCTs were included in this meta-analysis. These studies contained a total of 610 patients, in which 315 patients received a pulmonary ligament dissection (group D) after the upper lobectomy, while the other 295 patients preserved the pulmonary ligament (group P). No significant difference was demonstrated between the group D and group <jats:italic>P<\/jats:italic> in terms of drainage time after surgery (MD 0.14, 95%CI \u2212 0.05 to 0.33, <jats:italic>P<\/jats:italic> = 0.15), rate of postoperative dead space (OR 1.33, 95%CI 0.72 to 2.46, <jats:italic>P<\/jats:italic> = 0.36), rate of postoperative complications (OR 1.20, 95%CI 0.66 to 2.19, <jats:italic>P<\/jats:italic> = 0.56). However, the pooled comparison revealed a greater change of the right main bronchial angle (MD 5.00, 95%CI 1.68 to 8.33, <jats:italic>P<\/jats:italic> = 0.003) in group D compared with group P, indicated that the dissection of IPL may lead to a greater distortion of bronchus.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This meta-analysis confirmed that the dissection of IPL do not effectively reduce the postoperative complications and improve the prognosis. Therefore, it is not necessary to dissect the IPL after an upper lobectomy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-019-1777-3","type":"journal-article","created":{"date-parts":[[2020,1,4]],"date-time":"2020-01-04T12:02:57Z","timestamp":1578139377000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The choice of dissection or preservation of the inferior pulmonary ligament after an upper lobectomy: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"18","author":[{"given":"Hao","family":"Lv","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianghong","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongmei","family":"Di","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxian","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0465-076X","authenticated-orcid":false,"given":"Xiaoying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,4]]},"reference":[{"issue":"4","key":"1777_CR1","doi-asserted-by":"publisher","first-page":"504","DOI":"10.6004\/jnccn.2017.0050","volume":"15","author":"DS Ettinger","year":"2017","unstructured":"Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman J, Chirieac LR, et al. Non-small cell lung cancer, version 5.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2017;15(4):504\u201335.","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"1777_CR2","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.athoracsur.2013.07.117","volume":"97","author":"M Kent","year":"2014","unstructured":"Kent M, Wang T, Whyte R, Curran T, Flores R, Gangadharan S. Open, video-assisted thoracic surgery, and robotic lobectomy: review of a national database. Ann Thorac Surg. 2014;97(1):236\u201342 discussion 42-4.","journal-title":"Ann Thorac Surg"},{"issue":"3","key":"1777_CR3","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1016\/j.athoracsur.2005.06.066","volume":"81","author":"MS Allen","year":"2006","unstructured":"Allen MS, Darling GE, Pechet TT, Mitchell JD, Herndon JE, Landreneau RJ, et al. Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial. Ann Thorac Surg. 2006;81(3):1013\u20139 discussion 9-20.","journal-title":"Ann Thorac Surg"},{"issue":"11","key":"1777_CR4","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1007\/s00595-009-4173-8","volume":"40","author":"K Usuda","year":"2010","unstructured":"Usuda K, Sagawa M, Aikawa H, Tanaka M, Machida Y, Ueno M, et al. Do Japanese thoracic surgeons think that dissection of the pulmonary ligament is necessary after an upper lobectomy? Surg Today. 2010;40(11):1097\u20139.","journal-title":"Surg Today."},{"issue":"3","key":"1777_CR5","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1016\/S0003-4975(02)03764-5","volume":"74","author":"LJ Daniels","year":"2002","unstructured":"Daniels LJ, Balderson SS, Onaitis MW, D'Amico TA. Thoracoscopic lobectomy: a safe and effective strategy for patients with stage I lung cancer. Ann Thorac Surg. 2002;74(3):860\u20134.","journal-title":"Ann Thorac Surg"},{"issue":"1","key":"1777_CR6","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.jss.2015.09.030","volume":"201","author":"L Bu","year":"2016","unstructured":"Bu L, Yang AR, Peng H, Xu ZY, Wu JQ, Wang P. Dividing inferior pulmonary ligament may change the bronchial angle. J Surg Res. 2016;201(1):208\u201312.","journal-title":"J Surg Res"},{"issue":"2","key":"1777_CR7","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1093\/icvts\/ivt463","volume":"18","author":"Y Seok","year":"2014","unstructured":"Seok Y, Cho S, Lee JY, Yang HC, Kim K, Jheon S. The effect of postoperative change in bronchial angle on postoperative pulmonary function after upper lobectomy in lung cancer patients. Interact Cardiovasc Thorac Surg. 2014;18(2):183\u20138.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"1","key":"1777_CR8","first-page":"68","volume":"15","author":"S Asar","year":"2016","unstructured":"Asar S, Jalalpour S, Ayoubi F, Rahmani MR, Rezaeian M. PRISMA; Preferred Reporting Items for Systematic Reviews and Meta-Analyses. J Rafsanjan Univ Med Sci. 2016;15(1):68\u201380.","journal-title":"J Rafsanjan Univ Med Sci"},{"issue":"9","key":"1777_CR9","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","volume":"25","author":"A Stang","year":"2010","unstructured":"Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603\u20135.","journal-title":"Eur J Epidemiol"},{"issue":"12","key":"1777_CR10","first-page":"1308","volume":"46","author":"LL Ji","year":"2018","unstructured":"Ji LL, Li X, Zhu JP, Ren S, Sun DQ. Clinical observation of persistent cough after thoracoscopic lobectomy for preserved inferior pulmonary ligament in video-assisted thoracic surgery. Tianjin Med J. 2018;46(12):1308\u20139.","journal-title":"Tianjin Med J"},{"issue":"5","key":"1777_CR11","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1093\/icvts\/ivy344","volume":"28","author":"DH Kim","year":"2019","unstructured":"Kim DH, Moon DH, Kim HR, Lee SM, Chae EJ, Choi CM, et al. Effect of inferior pulmonary ligament division on residual lung volume and function after a right upper lobectomy. Interact Cardiovasc Thorac Surg. 2019;28(5):760\u20136.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"6","key":"1777_CR12","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1007\/s00595-004-2752-2","volume":"34","author":"H Matsuoka","year":"2004","unstructured":"Matsuoka H, Nakamura H, Nishio W, Sakamoto T, Harada H, Tsubota N. Division of the pulmonary ligament after upper lobectomy is less effective for the obliteration of dead space than leaving it intact. Surg Today. 2004;34(6):498\u2013500.","journal-title":"Surg Today."},{"issue":"1","key":"1777_CR13","first-page":"127","volume":"37","author":"HF Qi","year":"2016","unstructured":"Qi HF. Effects of releasing inferior pulmonary ligament in resecting right upper lobe of the lung under thoracoscope on postoperative compensatory dilation of the rest lung. Acad J Sec Mil Med Univ. 2016;37(1):127\u20138.","journal-title":"Acad J Sec Mil Med Univ"},{"issue":"2","key":"1777_CR14","first-page":"96","volume":"4","author":"WH Wang","year":"2017","unstructured":"Wang WH, Zhu ZJ, Yuan JB, Pang Y. Clinical observation of the effects of patients with lung cancer after surgery of releasing pulmonary ligament in resecting upper lobe of the lung under thoracoscope. Chin J Thorac Surg. 2017;4(2):96\u2013100.","journal-title":"Chin J Thorac Surg"},{"issue":"01","key":"1777_CR15","first-page":"1","volume":"5","author":"H Guo","year":"2018","unstructured":"Guo H, Diao YL, Fan HX, Shi QT, Feng K, Luo QQ. Clinical retrospective study of releasing the pulmonary ligament or not in the thoracoscope operation of the right upper lobe. Chin J Thorac Surg. 2018;5(01):1\u20135.","journal-title":"Chin J Thorac Surg"},{"key":"1777_CR16","first-page":"206","volume-title":"Preservation of the pulmonary ligament to prevent from deformation of the residual bronchus","author":"K Narita","year":"1997","unstructured":"Narita K, Iwanami H, Hiyoshi H, Tachibana M, Tsuboi E. Preservation of the pulmonary ligament to prevent from deformation of the residual bronchus; 1997. p. 206\u201310."},{"issue":"4","key":"1777_CR17","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1510\/icvts.2007.172007","volume":"7","author":"VK Kouritas","year":"2008","unstructured":"Kouritas VK, Hatzoglou C, Foroulis CN, Gourgoulianis KI. Human parietal pleura present electrophysiology variations according to location in pleural cavity. Interact Cardiovasc Thorac Surg. 2008;7(4):544\u20137.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"1","key":"1777_CR18","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1183\/09031936.97.10010219","volume":"10","author":"G Miserocchi","year":"1997","unstructured":"Miserocchi G. Physiology and pathophysiology of pleural fluid turnover. Eur Respir J. 1997;10(1):219\u201325.","journal-title":"Eur Respir J"},{"key":"1777_CR19","first-page":"160","volume":"34","author":"K Usuda","year":"2009","unstructured":"Usuda K. Severe basal bronchial stenosis related to dissection of pulmonary ligament. Report of a case. J Kanazawa Med Univ. 2009;34:160\u20132.","journal-title":"J Kanazawa Med Univ."},{"issue":"2","key":"1777_CR20","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1093\/icvts\/ivt144","volume":"17","author":"M Khanbhai","year":"2013","unstructured":"Khanbhai M, Dunning J, Yap KH, Rammohan KS. Dissection of the pulmonary ligament during upper lobectomy: is it necessary? Interact Cardiovasc Thorac Surg. 2013;17(2):403\u20136.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"1","key":"1777_CR21","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1586\/ers.09.68","volume":"4","author":"PJ Mazzone","year":"2010","unstructured":"Mazzone PJ. Preoperative evaluation of the lung cancer resection candidate. Expert Rev Respir Med. 2010;4(1):97\u2013113.","journal-title":"Expert Rev Respir Med"},{"issue":"3","key":"1777_CR22","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1016\/S0003-4975(01)03361-6","volume":"73","author":"M Riquet","year":"2002","unstructured":"Riquet M, Le Pimpec BF, Souilamas R, Hidden G. Thoracic duct tributaries from intrathoracic organs. Ann Thorac Surg. 2002;73(3):892\u20138 discussion 8-9.","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"1777_CR23","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1055\/s-2007-1016462","volume":"42","author":"A Terzi","year":"1994","unstructured":"Terzi A, Furlan G, Magnanelli G, Terrini A, Ivic N. Chylothorax after pleuro-pulmonary surgery: a rare but unavoidable complication. Thorac Cardiovasc Surg. 1994;42(2):81\u20134.","journal-title":"Thorac Cardiovasc Surg"},{"issue":"2","key":"1777_CR24","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1634\/theoncologist.6-2-147","volume":"6","author":"CI Henschke","year":"2001","unstructured":"Henschke CI, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Miettinen OS, et al. Early lung cancer action project: a summary of the findings on baseline screening. Oncologist. 2001;6(2):147\u201352.","journal-title":"Oncologist."},{"issue":"12","key":"1777_CR25","doi-asserted-by":"publisher","first-page":"2865","DOI":"10.1007\/s00268-012-1743-5","volume":"36","author":"Y Shimada","year":"2012","unstructured":"Shimada Y, Saji H, Kakihana M, Honda H, Usuda J, Kajiwara N, et al. Retrospective analysis of nodal spread patterns according to tumor location in pathological N2 non-small cell lung cancer. World J Surg. 2012;36(12):2865\u201371.","journal-title":"World J Surg"},{"issue":"2","key":"1777_CR26","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.jtcvs.2013.10.001","volume":"147","author":"S Su","year":"2014","unstructured":"Su S, Scott WJ, Allen MS, Darling GE, Decker PA, McKenna RJ, et al. Patterns of survival and recurrence after surgical treatment of early stage non-small cell lung carcinoma in the ACOSOG Z0030 (ALLIANCE) trial. J Thorac Cardiovasc Surg. 2014;147(2):747\u201353.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"7","key":"1777_CR27","doi-asserted-by":"publisher","first-page":"2102","DOI":"10.21037\/jtd.2017.06.04","volume":"9","author":"H Han","year":"2017","unstructured":"Han H, Chen H. Selective lymph node dissection in early-stage non-small cell lung cancer. J Thorac Dis. 2017;9(7):2102\u20137.","journal-title":"J Thorac Dis"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-019-1777-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12957-019-1777-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-019-1777-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T00:05:37Z","timestamp":1609632337000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-019-1777-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,4]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1777"],"URL":"https:\/\/doi.org\/10.1186\/s12957-019-1777-3","relation":{},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,4]]},"assertion":[{"value":"8 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 December 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All analyses were based on previous published studies, so no ethical approval and patient consent are required.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"5"}}