Phrenic Nerve Interventions for the Prevention and Management of Prolonged Air Leak and Residual Pleural Space After Pulmonary Resection: A Structured Narrative Review

Background and Objectives: Prolonged air leak (PAL) and residual pleural space (RPS) remain frequent complications after pulmonary resection. Temporary phrenic nerve modulation has been proposed to reduce pleural cavity volume by elevating the ipsilateral hemidiaphragm. Materials and Methods: This structured narrative review searched PubMed/MEDLINE, Scopus, and Google Scholar from inception to 30 June 2026 and screened reference lists. Direct evidence was defined as human post-resection studies reporting PAL, air-leak duration, drainage duration, or RPS; shoulder-pain, interscalene-block, historical, and preclinical studies were retained only as indirect mechanistic, technical, or safety context. Randomized trials and case series were appraised using RoB 2 and the JBI case-series tool, respectively.