Ultrasound evaluation in the postoperative period for surgical treatment of thoracic infectious and inflammatory diseases

• Published in: Clinics (São Paulo, Brazil) Brazil), 2024-01, Vol.79, p.100452, Article 100452
• Main Authors: Razuk Filho, Mauro, Minamoto, Fabio Eiti Nishibe, Mariani, Alessandro Wasum, D'Ambrosio, Paula Duarte, Rodrigues, Thiago Potrich, Chammas, Maria Cristina, Terra, Ricardo Mingarini, Pêgo-Fernandes, Paulo Manuel
• Format: Article
• Language: English
• Subjects: Adult; Aged; Chest Tubes; Drainage - methods; Female; Humans; Lung Diseases - diagnostic imaging; Lung Diseases - surgery; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Postoperative Complications - diagnostic imaging; Postoperative Period; Prospective Studies; Radiography; Radiography, Thoracic; Reproducibility of Results; Thoracic; Thoracic Cavity Thoracic Diseases; Thoracic surgery ultrasonography; Time Factors; Ultrasonography - methods; Young Adult
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.1016/j.clinsp.2024.100452

•TUSG aids post-op care, no radiation.•CXR limits: 2D, discomfort, radiation.•Study compares TUSG to CXR.•TUSG complements CXR, not a replacement. This study aims to evaluate the role of TUSG in the postoperative period and the detection of early complications after surgical treatment, pulmonary resection, or decortication for infectious and inflammatory thoracic diseases, comparing with the standard method (Chest Radiography ‒ CXR). Prospective non-randomized self-controlled study. Twenty-one patients over 16 years of age have undergone surgical treatment of inflammatory and infectious lung diseases. These patients were followed up with CXR and TUSG (performed on the 1st and 3rd postoperative days and/or after the chest tube removal). Both exams demonstrated similar results regarding their ability to safely predict the adequate moment for chest drain removal. TUSG allowed chest drain removal in 30% of cases and CXR in 34%. Statistical analysis demonstrates that both exams have similar capabilities in detecting postoperative changes in the pleural space. However, the authors report that TUSG is statistically more accurate in detecting subcutaneous emphysema than CXR (p = 0.037, Kappa [κ = 0.3068]). The analysis of other parameters showed no statistical difference. The authors conclude that TUSG in trained hands is equivalent to CXR in searching for postoperative complications regarding the surgical treatment of infectious and inflammatory thoracic diseases and can be used as a complement, and not a substitute, to CXR, when CCT is not feasible, or a more urgent diagnosis is needed.