{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:46:17Z","timestamp":1791261977860,"version":"4.1.0"},"reference-count":20,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: Residual postoperative pleural space (RPPS) is a common event after pulmonary lobectomy. Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy has been associated with a higher incidence of RPPS. This study aims to evaluate the incidence, the predictors, and potential clinical implications of RPPS following Uniportal VATS lobectomy. Methods: Patients who underwent Uniportal VATS lobectomy, without any previous neoadjuvant treatment, from June 2016 to March 2020, were retrospectively analyzed. RPPS was assessed using the last chest X-Ray prior to discharge and measured by Collins method (%). Results: Among 492 patients who underwent Uniportal VATS lobectomy, 325 (66.1%) developed RPPS. The mean RPPS volume measured by the Collins method was 15.46 \u00b1 8.59% (vs. Collins = 4.2% in no-PRPS). An RPPS &gt; 10.5% of Collins was significantly associated with a higher risk of postoperative air leak (AUC: 0.69, sensitivity: 69%, specificity: 54%, p &lt; 0.001). Multivariable analysis identified the following predictors of RPPS &gt; 10.5%: right-sided surgery (p &lt; 0.001), upper lobectomy (p = 0.01), and prolonged air leak (p = 0.003). Patients with RPPS had a higher risk of only radiologically visible postoperative subcutaneous emphysema on the final chest X-ray (p = 0.041) and were more frequently discharged with a chest tube connected to a Heimlich valve (p &lt; 0.001). Within 90 days post-discharge, 24 (4.9%) patients were readmitted due to increased RPPS (1.4%, requiring drainage in 5 cases [1%]), progression of subcutaneous emphysema (1.6%), and pleural effusion (1.8%, requiring drainage in 6 cases [1.2%]). However, RPPS was not associated with an increased overall risk of postoperative complications (p = 0.31) or 90-day readmission (p = 0.43). Conclusions: RPPS is a common occurrence following Uniportal VATS lobectomy but is not associated with clinically significant complications. The current study findings identified BMI, active smoking, right-sided surgery, and prolonged air leak as significant predictors of RPPS.<\/jats:p>","DOI":"10.3390\/jcm14144988","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T09:45:52Z","timestamp":1752572752000},"page":"4988","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predictors and Potential Clinical Implications of Residual Postoperative Pleural Space After Uniportal-Vats Lobectomy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7233-5809","authenticated-orcid":false,"given":"Maria Letizia","family":"Vita","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4058-5539","authenticated-orcid":false,"given":"Antonio Giulio","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9396-373X","authenticated-orcid":false,"given":"Adriana","family":"Nocera","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Leoni","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5102-1591","authenticated-orcid":false,"given":"Arianna","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6399-9171","authenticated-orcid":false,"given":"Khrystyna","family":"Kuzmych","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Petracca-Ciavarella","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5563-0331","authenticated-orcid":false,"given":"Maria Teresa","family":"Congedo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Meacci","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Lococo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Margaritora","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2937-9678","authenticated-orcid":false,"given":"Dania","family":"Nachira","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario \u201cA.Gemelli\u201d IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"ref_1","first-page":"39","article-title":"Definition of post resectional residual pleural space","volume":"50","author":"Solak","year":"2007","journal-title":"Can. 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Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/14\/4988\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:09:46Z","timestamp":1760033386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/14\/4988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":20,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["jcm14144988"],"URL":"https:\/\/doi.org\/10.3390\/jcm14144988","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,15]]}}}