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The negative impact of pleural adhesion on pulmonary function: a retrospective study
Zherui Shao1, Bin Wu1, Ni Li1
1Department of Cardiothoracic Surgery, Ningbo Medical Centre Lihuili Hospital, Ningbo University, No 57, Xingning Road, Ningbo, 315041, Ningbo, China.
Journal of Cardiothoracic Surgery
|May 14, 2026
Summary
Pleural adhesions significantly impair pulmonary function, especially when located on the chest wall or covering over 60% of the pleural surface. Understanding adhesion site and extent is crucial for preserving lung function.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Research
Background:
- Pleural adhesions are lesions between lung pleura, often asymptomatic but can impair pulmonary function.
- Limited research exists on mild/localized adhesions and their preoperative pulmonary function impact.
- This study investigates the specific effects of pleural adhesion site and extent on pulmonary function.
Purpose of the Study:
- To evaluate the impact of pleural adhesion site on pulmonary function.
- To assess the correlation between the extent of pleural adhesions and pulmonary function impairment.
- To provide evidence for interventions reducing postoperative adhesions and preserving lung function.
Main Methods:
- 199 pairs of patients undergoing right-sided thoracoscopic lung tumor resection were analyzed.
- Propensity score matching was used to reduce confounding factors.
- Factorial ANOVA, repeated measures ANOVA, Tukey's HSD, and Bonferroni corrections were applied.
Main Results:
- Pleural adhesion site significantly affected pulmonary function (P < 0.001).
- Chest wall adhesions caused more significant impairment in FEV1, RV, and TLC compared to other sites.
- Increased extent of adhesions correlated with greater pulmonary function impairment, with >60% surface area showing significant reductions (P < 0.001).
Conclusions:
- Both site and extent of pleural adhesion negatively impact pulmonary function.
- Chest wall adhesions and those exceeding 60% surface area cause the most significant impairment.
- Findings emphasize intraoperative awareness and preventive strategies for patients with extensive adhesions.
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