{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:53:35Z","timestamp":1793141615033,"version":"4.5.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Prolonged air leak (PAL) remains a significant surgical challenge after pulmonary resections and secondary spontaneous pneumothorax. Ventilation single-photon emission computed tomography combined with computed tomography (vSPECT\/CT) has emerged as a promising tool for air leak localization. This study evaluates the impact of preoperative vSPECT\/CT on surgical management of PAL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center study compared a prospectively enrolled vSPECT\/CT cohort (February 2021\u2013December 2025) with retrospective historical controls (January 2015\u2013January 2021). Propensity score matching generated two matched groups: with and without vSPECT\/CT. Primary outcome was vSPECT\/CT accuracy in detecting air leaks; secondary outcomes included chest tube duration, persistent PAL, reoperation rates, and hospital stay. Wilcoxon signed-rank and McNemar tests were used for comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 122 patients were included (52 vSPECT\/CT; 70 non-vSPECT\/CT). vSPECT\/CT showed a 95.3% concordance with intraoperative air leak localization. After matching, 86 patients (43 per group) were analyzed. The vSPECT\/CT group had shorter chest tube duration (median 2 vs. 4 days;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01) and hospital stay (median 3 vs. 5 days;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.036). Rates of persistent PAL and reoperation were similar between groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.057 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.375, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this prospectively enrolled cohort, preoperative vSPECT\/CT reliably localizes PAL, enabling focused surgical intervention and supporting more efficient postoperative recovery. Its use is associated with shorter chest tube duration and hospital stay, highlighting its value as a preoperative tool in the management of PAL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1780031","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:46:02Z","timestamp":1771915562000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Ventilation SPECT\/CT-guided air leak management: improving precision in a long-standing surgical challenge"],"prefix":"10.3389","volume":"13","author":[{"given":"Marta","family":"Fuentes","sequence":"first","affiliation":[{"name":"Service of Thoracic Surgery and Lung Transplantation, Salamanca University Hospital","place":["Salamanca, Spain"]},{"name":"Salamanca Institute of Biomedical Research","place":["Salamanca, Spain"]},{"name":"University of Salamanca","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Teresa","family":"G\u00f3mez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery and Lung Transplantation, Salamanca University Hospital","place":["Salamanca, Spain"]},{"name":"Salamanca Institute of Biomedical Research","place":["Salamanca, Spain"]},{"name":"University of Salamanca","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pe\u00f1aherrera Cepeda","sequence":"additional","affiliation":[{"name":"Service of Nuclear Medicine, Salamanca University Hospital","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rivas","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery and Lung Transplantation, Salamanca University Hospital","place":["Salamanca, Spain"]},{"name":"Salamanca Institute of Biomedical Research","place":["Salamanca, Spain"]},{"name":"University of Salamanca","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Aranda","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery and Lung Transplantation, Salamanca University Hospital","place":["Salamanca, Spain"]},{"name":"Salamanca Institute of Biomedical Research","place":["Salamanca, Spain"]},{"name":"University of Salamanca","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Colmenares","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery and Lung Transplantation, Salamanca University Hospital","place":["Salamanca, Spain"]},{"name":"Salamanca Institute of Biomedical Research","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Manama","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery and Lung Transplantation, Salamanca University Hospital","place":["Salamanca, Spain"]},{"name":"Salamanca Institute of Biomedical Research","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"G\u00f3mez-Caminero","sequence":"additional","affiliation":[{"name":"University of Salamanca","place":["Salamanca, Spain"]},{"name":"Service of Nuclear Medicine, Salamanca University Hospital","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Tamayo","sequence":"additional","affiliation":[{"name":"University of Salamanca","place":["Salamanca, Spain"]},{"name":"Service of Nuclear Medicine, Salamanca University Hospital","place":["Salamanca, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo F.","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Service of Thoracic Surgery and Lung Transplantation, Salamanca University 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