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Thorac Cardiovasc Surg 2017; 65(07): 572-580
DOI: 10.1055/s-0037-1599793
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

The Interest of Performing “On-Demand Chest X-rays” after Lung Resection by Minimally Invasive Surgery

Laura Haddad
1   Unit of Thoracic Surgery, University Hospital of Rouen, Rouen, France
,
Michael Bubenheim
2   Unit of Biostatistic, University Hospital of Rouen, Rouen, France
,
Alain Bernard
3   Unit of Thoracic Surgery, University Hospital of Dijon, Dijon, France
,
Jean Melki
1   Unit of Thoracic Surgery, University Hospital of Rouen, Rouen, France
,
Christophe Peillon
1   Unit of Thoracic Surgery, University Hospital of Rouen, Rouen, France
,
Jean-Marc Baste
1   Unit of Thoracic Surgery, University Hospital of Rouen, Rouen, France
4   Inserm U1096, Rouen Institute for Research and Innovation in Biomedicine, Rouen, France
› Author Affiliations
Further Information

Publication History

07 November 2016

17 January 2017

Publication Date:
11 April 2017 (online)

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Abstract

Background There is a lack of consensus in hospital centers regarding costly daily routine chest X-rays after lung resection by minimally invasive surgery. Indeed, there is no evidence that performing daily chest X-rays prevents postoperative complications. Our objective was to compare chest X-rays performed on demand when there was clinical suspicion of postoperative complications and chest X-rays performed systematically in daily routine practice.

Methods This prospective single-center study compared 55 patients who had on-demand chest X-rays and patients in the literature who had daily routine chest X-rays. Our primary evaluation criterion was length of hospitalization.

Results The length of hospitalization was 5.3 ± 3.3 days for patients who had on-demand X-rays, compared with 4 to 9.7 days for patients who had daily routine X-rays. Time to chest tube removal (4.34 days), overall complication rate (27.2%), reoperation rate (3.6%), and mortality rate (1.8%) were comparable to those in the literature. On average, our patients only had 1.22 ± 1.8 on-demand X-rays, compared with 3.3 X-rays if daily routine protocol had been applied. Patients with complications had more X-rays (3.4 ± 1.8) than patients without complications (0.4 ± 0.7).

Conclusion On-demand chest X-rays do not seem to delay the diagnosis of postoperative complications or increase morbidity–mortality rates. Performing on-demand chest X-rays could not only simplify surgical practice but also have a positive impact on health care expenses. However, a broader randomized study is warranted to validate this work and ultimately lead to national consensus.

Keywords

lung cancer - diagnosis - minimally invasive surgery - postoperative complication - surgery - complications - VATS
 

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