Fissureless fissure-last video assisted thoracoscopic lobectomy: always? never? sometimes

Lung surgery has changed during the last decade and video-assisted thoracic surgery (VATS) techniques have been introduced and implemented with the aim to reduce hospital stay, perioperative complications, and to obtain a faster recovery to habitual activities. However, one of the commonest complications after lung surgery still remains prolonged air leak (PAL), reported in 8–15% of cases and leading to a longer chest tube duration, length of stay (LOS), and consequently to higher costs and more risks of pleural infections (1,2).