Can Chest Ultrasound Replace Chest X-ray in Thoracic Surgery?

Abstract

Background: There is growing evidence that supports the use of chest ultrasound (CUS) versus conventional chest X-ray (CXR) in order to diagnose postoperative complications. However, data regarding its use after thoracic surgery are scarce and contradictory. The aim of this study was to conduct a systematic review to evaluate the accuracy of CUS after thoracic surgery. Methods: An electronic search in MEDLINE (via PubMed), complemented by manual searches in article references, was conducted to identify eligible studies. Results: Six studies with a total of 789 patients were included in this meta-analysis. Performing CXR decreased in up to 61.6% of cases, with the main reasons for performing CXR being massive subcutaneous emphysema or complex hydrothorax. Agreement between CUS and routine-based therapeutic options was, in some studies, up to 97%. Conclusions: The selectively postoperative use of CUS may reduce the number of routinely performed CXR. However, if CUS findings are inconclusive, further radiological examinations are obligatory.

The anesthesia management of totally thoracoscopic cardiac surgery: A single-center retrospective study

“…Ultrasound-guided SAPB was performed with 30 ml of 0.33% ropivacaine before surgery. The visual analog pain score (VAS) was performed immediately after the patient recovery from anesthesia, and 10 mg of morphine was given when the VAS score was greater than 4, the total consumption per day does not exceed 40 mg. Post-operative chest X-ray (CXR): Although efforts and suggestions have been made to reduce the number of post-operative CXR [ 43 ], for early detection of postoperative pulmonary complications, all patients in our center received CXR on the first and third day after TTCS, respectively. Antibiotics should be given early if the CXR indicates pneumonia.…”

“…Post-operative chest X-ray (CXR): Although efforts and suggestions have been made to reduce the number of post-operative CXR [ 43 ], for early detection of postoperative pulmonary complications, all patients in our center received CXR on the first and third day after TTCS, respectively. Antibiotics should be given early if the CXR indicates pneumonia.…”

Lung Ultrasound Reduces Chest X-rays in Postoperative Care after Thoracic Surgery: Is There a Role for Artificial Intelligence?—Systematic Review

“…As mentioned above, several trials have shown that LUS could represent an alternative approach to decrease the CXR in the postoperative period after non-cardiac thoracic surgery and thus lower the radiation [ 38 ]. In 2012, Goudie et al published the first relevant clinical trial conducted in thoracic surgery regarding the use of LUS in postoperative care [ 15 ].…”