Routinely obtained chest X-rays after elective video-assisted thoracoscopic surgery can be omitted in most patients: a retrospective, observational study
Research output: Contribution to journal › Journal article › Research › peer-review
OBJECTIVE: To investigate whether the use of routinely obtained chest X-rays is necessary after elective VATS.
METHODS: We retrospectively reviewed 1097 chest X-rays obtained routinely after elective VATS, performed in patients aged over 15 years during an 18-month period. VATS procedures were divided into three groups according to the degree of pulmonary resection. The chest X-rays (obtained anterior-posterior in one plane with the patient in the supine position) were categorized as abnormal if showing pneumothorax >5 cm, possible intra-thoracic bleeding and/or a displaced chest tube. Medical charts were reviewed for all patients with abnormal chest X-rays to see if an intervention was made based on the X-ray. In case of an intervention, detailed clinical data were collected.
RESULTS: 44 of 1097 chest X-rays (4.0 %) were abnormal and 10 of these X-rays (0.9 %) led to a clinical intervention. Proportions of abnormal chest X-rays were unequally distributed between groups (p < 0.001), whereas the number of interventions was not (p = 0.43). Of the ten chests X-rays that led to an intervention, three showed possible intra-thoracic bleeding, six showed pneumothorax >5 cm and one showed a kinked chest tube. All the patients with possible intra-thoracic bleeding were re-explored in the operating theatre the same day.
CONCLUSIONS: Only 10 of 1097 chest X-rays (0.9 %) obtained routinely after elective VATS procedures led to a clinical intervention, supporting the abandon of routine chest X rays in favour of a more individualised approach, based on clinical observations.
Original language | English |
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Journal | General Thoracic and Cardiovascular Surgery |
Volume | 63 |
Issue number | 8 |
Pages (from-to) | 465-71 |
Number of pages | 7 |
ISSN | 1863-6705 |
DOIs | |
Publication status | Published - Aug 2015 |
Externally published | Yes |
- Adolescent, Adult, Aged, Aged, 80 and over, Chest Tubes, Elective Surgical Procedures/methods, Equipment Failure, Female, Humans, Lung Diseases/diagnostic imaging, Male, Middle Aged, Pneumothorax/diagnostic imaging, Postoperative Care/methods, Radiography, Thoracic/statistics & numerical data, Retrospective Studies, Thoracic Surgery, Video-Assisted/methods
Research areas
ID: 226260305