Over 2 million thoracoscopic pulmonary resections are performed globally each year,however,postoperative persistent air leak(PAL)remains a common and challenging complication.It not only prolongs hospital stays and increases treatment costs but may also lead to severe complica-tions,particularly inducing a higher risk in patients undergoing mechanical ventilation.In recent years,with the improvement of preoperative preventive measures,the advancement of surgical tech-niques,and the application of repair materials,the incidence of PAL has decreased.This review sys-tematically summarized the definition,clinical impact,risk factors and preventive strategies of PAL,and explored commonly used treatment modalities,such as thoracic drain management,pleurodesis and the application of novel repair materials.It also analyzed the effectiveness,safety and challenges of existing techniques.Furthermore,this review proposed the establishment of an enhanced recovery after surgery(ERAS)integrated pathway combining bovine pericardium(BP)patch with electro-me-chanical stapler and conducted corresponding treatment benefit-cost assessment.

Objective To explore Angptl2(angiopoietin-like protein 2)expression in tumor tis-sue and serum in patients with breast cancer(BC). Methods A total of 78 BC patients were enrolled in this study. Immunohistochemistry was used to detect Angptl2 expression in tumor and adjacent normal tis-sues. Preoperative and postoperative serum Angptl2 levels were determined via ELISA. Correlation among Angptl2 expression,clinicopathological factors and progression-free survival(PFS)were further evalua-ted. The receiver operating characteristics(ROC)curve was constructed to describe diagnostic specificity and sensitivity. Results Angptl2 was positively expressed in 64(82. 1% )cases. The rates of high and moderate expression of Angpt l2 in tumor and adjacent tissues were 53. 8%(42 / 78)and 7. 7%(6 / 78), respectively(P ﹤ 0. 001). Moreover,the elevated Angptl2 protein was significantly associated with lymph metastasis and adverse PFS. In addition,serum Angptl2 level in BC patients was significantly higher than that in benign controls[(218. 72 ± 88. 02)vs(80. 88 ± 30. 59)ng/ ml,P ﹤ 0. 01]. The area under the curve(AUC)was 0. 909,which indicated a good function for diagnosis. Postoperative serum Angptl2 level was decreased to(142. 43 ± 60. 29)ng/ ml,but still higher than that in controls(P ﹤ 0. 01). Conclusion The expression of Angptl2 may increase in tumor tissue and serum of BC and it may be a potential tumor marker for diagnosis and prognosis.