The Interest of Performing "On-Demand Chest X-rays" after Lung Resection by Minimally Invasive Surgery.
Fiche publication
Date publication
avril 2017
Journal
The Thoracic and cardiovascular surgeon
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BERNARD Alain
Tous les auteurs :
Haddad L, Bubenheim M, Bernard A, Melki J, Peillon C, Baste JM
Lien Pubmed
Résumé
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.
Mots clés
Aged, Chest Tubes, Drainage, instrumentation, France, Health Services Needs and Demand, Humans, Length of Stay, Male, Middle Aged, Pneumonectomy, adverse effects, Postoperative Complications, diagnostic imaging, Predictive Value of Tests, Prospective Studies, Radiography, Thoracic, Robotic Surgical Procedures, adverse effects, Thoracic Surgery, Video-Assisted, adverse effects, Time Factors, Treatment Outcome
Référence
Thorac Cardiovasc Surg. 2017 Apr;: