Journal of thoracic disease最新文献

{"title":"Construction and validation of a predictive model for postoperative respiratory failure in esophageal cancer patients.","authors":"Bo Yang, Yue Bai, Lili Lang, Jijun Xue, Qun Cao, Yong Ao","doi":"10.21037/jtd-2024-2114","DOIUrl":"10.21037/jtd-2024-2114","url":null,"abstract":"<p><strong>Background: </strong>Postoperative respiratory failure (PRF) is one of the most severe complications following esophageal cancer (EC) surgery, closely associated with high mortality and poor prognosis. Early diagnosis and intervention are crucial. This study aimed to explore the risk factors for PRF in EC, develop a predictive model, and validate its performance.</p><p><strong>Methods: </strong>The clinical data of 265 EC patients who underwent surgery at the Sun Yat-sen University Cancer Center Gansu Hospital between January 2020 and June 2024 were retrospectively analyzed. The patients were randomly divided 7:3 into a training set (n=185) and an internal validation set (n=80). Another 80 EC patients who underwent surgery at the Sun Yat-sen University Cancer Center between January 2024 and June 2024 were employed as an external validation set. Feature selection was optimized using least absolute shrinkage and selection operator (LASSO)-logistic regression, and a predictive model was constructed and internally and externally validated.</p><p><strong>Results: </strong>Smoking index ≥400, forced expiratory volume in one second (FEV1), preoperative serum albumin level, surgical time, and postoperative anastomotic fistula were identified as risk factors for PRF in EC patients. The area under the curve (AUC) values of the predictive model were as follows: training set (0.856), internal validation set (0.839), and external validation set (0.773), indicating that the model had good discriminatory power. A calibration curve and Hosmer-Lemeshow test demonstrated that the model had favorable predictive accuracy and decision curve analysis (DCA) showed that the model had considerable clinical utility.</p><p><strong>Conclusions: </strong>The predictive model developed using LASSO-logistic regression exhibited strong performance and clinical applicability in both internal and external validations, with the potential to assist clinicians in identifying high-risk patients for early individualized intervention.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"4978-4989"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of non-intubation anesthesia based on a fentanyl-reduced regimen on hypoxemia during bronchoscopy for older patients: study protocol for a randomized controlled trial.","authors":"An Xie, Xianjie Zhang, Jia Han, Rui Zhou","doi":"10.21037/jtd-2025-475","DOIUrl":"10.21037/jtd-2025-475","url":null,"abstract":"<p><strong>Background: </strong>Older patients are more likely to suffer from cardiopulmonary events during sedation-based bronchoscopy. It is important to balance the inhibition of stress and cardiopulmonary function, particularly for the elderly. This randomized controlled trial aims to investigate a fentanyl-reduced regimen on hypoxemia during bronchoscopy for older patients.</p><p><strong>Methods: </strong>Eligible patients will be randomly allocated to the study group or control group. Medication regimen for the study group is remimazolam 0.2 mg/kg + esketamine 0.3 mg/kg + fentanyl 0.5 µg/kg, whereas those in the control group will receive remimazolam 0.2 mg/kg + fentanyl 1.5 µg/kg. Remimazolam 0.05 mg/kg will serve as top-ups for both groups. The primary outcome is the incidence of hypoxemia during bronchoscopy. The secondary outcomes include rates of successful examination, awakening time, discharge time, quality of recovery, satisfactory scores of patients and the endoscopist, incidences of hypotension or hypertension and body movement (cough, swing of the limbs, etc.).</p><p><strong>Discussion: </strong>The present study aims to assess the effects of a fentanyl-reduced protocol on bronchoscopy for older patients. The results are supposed to be that the fentanyl-reduced regimen can provide sufficient sedation for geriatric bronchoscopy with fewer adverse events, which is worthy of clinical adoption.</p><p><strong>Trial registration: </strong>The trial has been registered at Chinese Clinical Trial Registry (ChiCTR2400084672).</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"5388-5395"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors for change in cough-related quality of life and symptom severity in acute cough: results of an observational pharmacy-based study.","authors":"Karl Philipp Drewitz, Claudia B Bittner, Katharina Piontek, Michael Plach, Christoph Abels, Christian J Apfelbacher","doi":"10.21037/jtd-2024-1972","DOIUrl":"10.21037/jtd-2024-1972","url":null,"abstract":"<p><strong>Background: </strong>Acute cough is a common symptom, frequently linked to respiratory tract infections. Although self-limiting, acute cough can significantly affect patients' quality of life (QoL), causing discomfort, disrupting sleep, and hindering daily activities. Identifying factors contributing to changes in cough-related QoL (crQoL) and severity of symptoms (SoS) is essential for developing personalised treatment approaches and enhancing patient care. The aim of this study was to investigate predictors for change in crQoL and SoS in individuals with acute cough due to respiratory tract infections using the thyme/ivy herbal fluid extract BNO 1200 (Bronchipret^® drops).</p><p><strong>Methods: </strong>We retrospectively analysed data from an observational/non-interventional pharmacy-based study on the effectiveness and tolerability of BNO 1200 for the treatment of acute cough due to respiratory tract infections. CrQoL and SoS were measured with the Leicester Cough Questionnaire (LCQ) and a patient-adapted version of the Bronchitis Severity Score (BSS), respectively. Change was defined as differences of LCQ and BSS scores before and after treatment with BNO 1200. We included age, sex, smoking status, cough severity and duration of symptoms before taking BNO 1200 as predictors for change in crQoL and SoS in multivariable regression analyses. Regarding clinically meaningful crQoL improvement (LCQ differences of ≥2 points), logistic regression analysis was performed, respectively. We derived β-estimates or odds ratios (ORs) with 95% confidence interval (CI).</p><p><strong>Results: </strong>Data from 674 participants (mean age 44.7 years, 66.2% female) with acute cough due to respiratory tract infections were analysed. LCQ and BSS scores showed a mean change of 6.3 points (95% CI: 6.0 to 6.5) and 6.2 points (95% CI: 5.9 to 6.5) from baseline to follow-up, respectively. Further, 615 participants (91.2%) showed an improvement in LCQ scores of ≥2 points. Analyses on predictors for change in crQoL revealed that lower crQoL prior to treatment and longer duration of intake of BNO 1200 were significantly associated with crQoL change. When clinically meaningful crQoL improvement was considered, greater cough severity prior to treatment and lower crQoL before treatment were statistically significant predictors. Regarding SoS, crQoL prior to treatment (LCQ baseline values), longer duration of intake of BNO 1200, greater symptom severity prior to treatment (BSS baseline values) and younger age were significantly associated with greater change.</p><p><strong>Conclusions: </strong>Factors predicting change in crQoL and SoS in acute cough due to respiratory tract infections were mainly at the level of symptom severity, treatment duration and crQoL prior to treatment with BNO 1200.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"4600-4609"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy in patients with pulmonary hypertension: a systematic review and meta-analysis with meta-regression.","authors":"Mahmoud El Iskandarani, Reshma Golamari, Branco G M Bettinotti, Elias Akiki, Daniela Urina Jassir, Tarec K Elajami, Francine K Welty, Esteban Escolar, Christos G Mihos","doi":"10.21037/jtd-2025-430","DOIUrl":"10.21037/jtd-2025-430","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy in patients with significant pulmonary hypertension (PH) is a contraindication due to high maternal and fetal mortality. However, recent data shows that an increasing number of women with PH are successfully carrying pregnancies to term, likely because of advancements in multidisciplinary care and treatment. This systematic review and meta-analysis aims to evaluate recent outcomes and identify risk factors associated with morbidity and mortality in this high-risk group.</p><p><strong>Methods: </strong>An unrestricted search was conducted across MEDLINE, EMBASE, and Cochrane databases for studies on outcomes in pregnant patients with PH from inception until May 30, 2024. For one-group analyses, event rates and 95% confidence interval (CI) were calculated using a random-effects model. Meta-regression was performed with Comprehensive Meta-Analysis version 4, employing covariates in logistic regression models. For two-group comparisons, odd ratios (ORs) and 95% CIs were calculated using Review Manager version 5.4 utilizing a random-effects model.</p><p><strong>Results: </strong>Fifty-one studies involving 4,583 pregnant patients with PH were included. The maternal mortality rate was 7.6% (95% CI: 5.8-9.9%). Most deaths (93%) occurred in the postpartum period. Severe PH was associated with a significantly higher rate of maternal mortality compared to mild/moderate PH with OR 5.57 (95% CI: 3.12-9.94). Higher systolic pulmonary artery pressure (sPAP) was associated with a higher mortality rate with a regression coefficient of 0.96. Similarly, the presence of Eisenmenger syndrome (ES) was linked to a higher mortality rate with a regression coefficient of 1. Severe PH was also associated with higher rates of abortion (OR =3.64, 95% CI: 2.61-5.09), prematurity (OR =2.52, 95% CI: 1.66-3.81), and small gestational age (OR =3.96, 95% CI: 2.96-5.29) compared with mild/moderate PH.</p><p><strong>Conclusions: </strong>Although the outcomes of pregnant patients with PH continue to improve, severe PH continues to be associated with a high mortality rate, abortion rate, prematurity, and small gestational age. Our findings support the existing consensus against pregnancy in severe PH and emphasize the need for thorough, individualized discussions about risks for patients with mild/moderate PH.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"5108-5121"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic azithromycin for chronic lung allograft dysfunction following lung transplantation: a systematic review and meta-analysis.","authors":"Heng Huang, Taketo Kato, Yoshito Imamura, Shoji Okado, Yuji Nomata, Hiroki Watanabe, Yuta Kawasumi, Jing Chen, Yuka Kadomatsu, Harushi Ueno, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa","doi":"10.21037/jtd-2025-365","DOIUrl":"10.21037/jtd-2025-365","url":null,"abstract":"<p><strong>Background: </strong>Azithromycin (AZI) has proven effective in improving pulmonary function and survival in certain patients with established chronic lung allograft dysfunction (CLAD) following lung transplantation (LTx), but its prophylactic effects on CLAD remain controversial. This study aimed to assess the outcomes of prophylactic AZI for CLAD following LTx.</p><p><strong>Methods: </strong>A systematic review was conducted based on PubMed, Embase and Cochrane Library. All included studies reported the primary or secondary outcomes in the prophylactic azithromycin (pAZI) and control groups. The CLAD onset, disease-free survival and overall survival (OS) data were pooled using fixed-effect or random-effect models. Sensitivity analysis was employed to evaluate the robustness of the pooled results, while a funnel plot was utilized to assess the publication bias.</p><p><strong>Results: </strong>Six eligible studies involving 1,251 LTx recipients were included. The pooled analysis revealed a lower risk of CLAD onset in the pAZI group compared to the control group [relative risk (RR) 0.64, 95% confidence interval (CI): 0.51-0.81, P<0.001]. Moreover, the pAZI group exhibited superiority in the 3-year [hazard ratio (HR) 0.57, 95% CI: 0.39-0.83, P=0.003] and 5-year CLAD-free survival (HR 0.61, 95% CI: 0.43-0.86, P=0.005); but this superiority was not observed in the 3-year (HR 0.69, 95% CI: 0.31-1.54, P=0.36) and 5-year OS (HR 0.59, 95% CI: 0.30-1.14, P=0.12).</p><p><strong>Conclusions: </strong>Prophylactic AZI may reduce the risk of CLAD onset and improve 3- and 5-year CLAD-free survival, providing supporting evidence for its application in LTx community. More high-quality and well-designed studies are warranted to determine the prophylactic effects of AZI on CLAD and its phenotypes following LTx.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"4395-4408"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchodilators and inhaled corticosteroids use in major global bronchiectasis registries.","authors":"Grace Oscullo, Alberto García-Ortega, Wei-Jie Guan, Miguel Ángel Martinez-García","doi":"10.21037/jtd-2025-962","DOIUrl":"10.21037/jtd-2025-962","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"5396-5401"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"McKeown minimally invasive esophagectomy under discontinuous spontaneous ventilating anesthesia by laryngeal mask: a retrospective non-inferiority cohort study.","authors":"Hui Liu, Jianfeng Chen, Yanran Zhou, Huanghe He, Zhuoyi Li, Hanyu Yang, Lixia Liang, Jianxing He, Jun Liu","doi":"10.21037/jtd-2024-2272","DOIUrl":"10.21037/jtd-2024-2272","url":null,"abstract":"<p><strong>Background: </strong>McKeown minimally invasive esophagectomy (MIE-McKeown) is a safe and feasible surgical method. However, the conventional anesthetic management with endotracheal intubation for MIE-McKeown is associated with high respiratory morbidity. The discontinuous spontaneous ventilating anesthesia by laryngeal mask may have advantages over conventional intubated anesthesia in MIE-McKeown. This study was designed to describe the techniques and evaluate the feasibility of discontinuous spontaneous ventilating anesthesia by laryngeal mask for MIE-McKeown.</p><p><strong>Methods: </strong>Between October 2022 and September 2024, 33 patients underwent MIE-McKeown at First Affiliated Hospital of Guangzhou Medical University. The study cohort was divided into a discontinuous spontaneous ventilating anesthesia group (Group A) and an intubated anesthesia group (Group B). We retrospectively compared the characteristics and perioperative outcomes of patients who underwent MIE-McKeown.</p><p><strong>Results: </strong>The clinical characteristics of Group A were not different from Group B except for gender. Non-inferiority analysis demonstrated that in Group A, both the lowest pulse oxygen saturation (SpO₂) and peak end-tidal carbon dioxide (EtCO₂) during cervical and abdominal procedures were non-inferior to those in Group B. Although the peak EtCO₂ during thoracic procedure was significantly higher in Group A than in Group B (57.05±9.12 <i>vs.</i> 45.38±3.97 mmHg, P<0.001), no severe hemodynamic changes, progressive decrease of SpO₂ or requirement conversion to intubated anesthesia were observed. In Group A, pleural effusion occurred in one patient, respiratory failure occurred in one patient. In Group B, and respiratory failure occurred in two patients and paralysis of recurrent laryngeal nerve (RLN) occurred in one patient. There were no cases of perioperative mortality.</p><p><strong>Conclusions: </strong>The technique of discontinuous spontaneous ventilating anesthesia by laryngeal mask for MIE-McKeown is considered feasible. Careful evaluation of the patients, preoperative assessment and skillful surgical technique are the key factors of successful discontinuous spontaneous ventilating anesthesia by laryngeal mask for MIE-McKeown. The discontinuous spontaneous ventilating anesthesia by laryngeal mask can be a valid alternative to the conventional intubated anesthesia for MIE-McKeown.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"5014-5023"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative review of diagnostic yield of navigational bronchoscopy for pulmonary nodules-a call for standardization.","authors":"Rodrigo Funes-Ferrada, Alanna Barrios-Ruiz, Alejandra Yu Lee-Mateus, Sofia Valdes-Camacho, Bryan F Vaca-Cartagena, Kelly S Robertson, Sebastian Fernandez-Bussy, David Abia-Trujillo","doi":"10.21037/jtd-24-1469","DOIUrl":"10.21037/jtd-24-1469","url":null,"abstract":"<p><strong>Background and objective: </strong>Lung cancer remains the leading cause of cancer-related mortality worldwide, with peripheral pulmonary lesions (PPLs) being increasingly identified through screening programs. Navigational bronchoscopy, including electromagnetic and robotic-assisted bronchoscopy, is pivotal for biopsying these lesions. However, inconsistent definitions of diagnostic yield (DY) across studies hinder accurate assessment of bronchoscopy performance. This narrative review aims to clarify current DY definitions and advocate for a standardized approach.</p><p><strong>Methods: </strong>A narrative review of articles from January 2019 to July 2024 was conducted using PubMed, focusing on DY and its calculation in bronchoscopic procedures.</p><p><strong>Key content and findings: </strong>This review highlights significant inconsistencies in DY definitions, with some studies including follow-up assessments and nonspecific benign (NSB) findings, while others only consider immediate specific benign (SB) and malignant results. These discrepancies result in wide-ranging reported DY values, from 26.7% to 97%. Additionally, the review underscores the importance of distinguishing between DY and diagnostic accuracy (DA), as they assess different aspects of procedural performance and should not be used interchangeably. Simulation studies also demonstrate that cancer prevalence and methodological differences in DY calculation substantially affect study outcomes. Standardizing DY as a measure based solely on immediate SB and malignant findings-without follow-up-would allow faster study times and for easier comparison across different studies. Reporting disease prevalence within the study population is highly relevant as higher prevalence may inflate reported DY values.</p><p><strong>Conclusions: </strong>A standardized, strict definition of DY is crucial for accurately evaluating the diagnostic capacity of bronchoscopy. DY should not be confused with DA, as they measure distinct elements of performance. Adopting a strict definition of DY will enhance the comparability of study results, promote evidence-based decision-making, and help reduce unnecessary procedures while improving the reliability of diagnostic assessments in clinical practice.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"5361-5370"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung ultrasound as a diagnostic tool for pulmonary consolidation and atelectasis after cardiac surgery.","authors":"Dabing Huang, Zhitao Li, Jianfeng Zhao, Hui Li, Wei Wang, Shuiqiao Fu","doi":"10.21037/jtd-2025-370","DOIUrl":"10.21037/jtd-2025-370","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary consolidation and atelectasis (PCA) are common complications following cardiac surgery, significantly impacting patient prognosis. This study aims to explore the diagnostic and prognostic applications of lung ultrasound (LUS) for PCA.</p><p><strong>Methods: </strong>This study enrolled patients undergoing cardiac surgery who received LUS, chest X-ray (CXR), and chest computed tomography (CT) within 24 hours postoperatively. Using CT as the gold standard for PCA diagnosis, we evaluated the diagnostic accuracy of LUS and CXR. Additionally, we analyzed the correlation between the lung ultrasound score (LUSS), quantitative lung ventilation parameters, and clinical outcomes.</p><p><strong>Results: </strong>Among 66 patients, 60 were diagnosed with PCA by CT. LUS demonstrated superior diagnostic accuracy compared to CXR [the area under the curve (AUC) =0.808 <i>vs.</i> 0.608]. The agreement between LUS and CT findings was moderate (Kappa =0.574). LUSS showed significant correlations with lung infiltration (r=0.398, P<0.001), lung collapse (r=0.328, P=0.007), PCA severity (r=0.606, P<0.001), CT score (r=0.401, P<0.001), and intensive care unit (ICU) stay (r=0.347, P=0.004). However, no significant correlations were observed between LUSS and duration of mechanical ventilation (r=0.159, P=0.20) or total hospital stay (r=0.144, P=0.25).</p><p><strong>Conclusions: </strong>LUS exhibits higher diagnostic accuracy for PCA compared to CXR. While LUSS correlates with ICU stay, it does not influence the duration of mechanical ventilation or total hospital stay.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"4794-4802"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous percutaneous microwave ablation combined with percutaneous biopsy for highly suspected malignant pulmonary nodules: a retrospective study.","authors":"Yining Liang, Biao Song, Bing Wang, Dongpo Wang, Chenghai Li, Wei Kang, Dailun Hou","doi":"10.21037/jtd-2025-105","DOIUrl":"10.21037/jtd-2025-105","url":null,"abstract":"<p><strong>Background: </strong>There is still a lack of studies on the optimal sequence of treatment for microwave ablation (MWA) combined with percutaneous biopsy (PB) in the treatment of highly suspected malignant pulmonary nodules (PNs). This study aimed to investigate the feasibility, safety, and efficacy of computed tomography (CT)-guided simultaneous MWA combined with PB in the treatment of highly suspected malignant PNs and discuss the influence of the sequential order of MWA and PB on the treatment outcome.</p><p><strong>Methods: </strong>From January 2021 to December 2024, 91 patients with single highly suspected malignant PNs underwent synchronous MWA combined with PB. A total of 56 patients in group A underwent synchronous MWA followed by PB (MWA-first group) and 35 cases in group B underwent synchronous PB followed by MWA (PB-first group). The technical success, pathologically positive diagnosis rate, complications, and efficacy of the two groups were compared.</p><p><strong>Results: </strong>The differences in technical success rate (100% <i>vs.</i> 97.1%) and positive pathologic diagnosis rate (80.4% <i>vs.</i> 88.6%) between group A and group B were not statistically significant (P>0.05). The most common complications included pneumothorax, intrapulmonary hemorrhage, hemoptysis, and pleural effusion. The incidence of intrapulmonary hemorrhage was significantly lower in group A than in group B (19.6% <i>vs.</i> 42.8%, P<0.05). The median follow-up time was 18.0 months, the local control rate was 98.8%, and the complete ablation (CA) rate was 56.6%.</p><p><strong>Conclusions: </strong>Synchronous MWA combined with PB is a safe and effective strategy. MWA followed by PB could reduce the impact of intrapulmonary hemorrhage on ablation outcomes and is an alternative treatment for highly suspected malignant PN.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 7","pages":"4768-4781"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}