Repetitive Imaging following Minimally Invasive Repair of Pectus Excavatum Is Unnecessary

Abstract

These data suggest that increased repetitive imaging after an initial postoperative CXR does not affect clinical outcomes and may not be necessary after MIRPE.

The use of lung ultrasound compared to chest X‐ray to diagnose pneumothorax following the Nuss procedure for pectus excavatum repair in children

“…exposes patients to ionizing radiation. [7][8][9]14 Third, the low interobserver agreement between R1 and R2 is consistent with the low sensitivity of chest X-ray for pneumothorax detection. 26 However, it is important to note that the assessments made by R2 were retrieved from the radiological reports and were not made specifically focused on the research purpose of this study.…”

“…First, lung ultrasound was associated with better inter‐reader agreement compared with chest X‐ray for recognizing small subclinical pneumothorax, regardless of the experience of the various figures involved. Second, the agreement between lung ultrasound operators and R1 was low, suggesting that the use of postoperative chest X‐ray is of limited clinical value and unnecessarily exposes patients to ionizing radiation 7‐9,14 . Third, the low inter‐observer agreement between R1 and R2 is consistent with the low sensitivity of chest X‐ray for pneumothorax detection 26 .…”

“…In our institute, it is routine practice to evaluate the presence of pneumothorax by means of a chest X‐ray examination at the end of the surgery before the patient awakes from general anesthesia. A second chest X‐ray is also performed, usually 1 week after surgery, before the patient is discharged home 7,8 . The present study focuses on the first chest X‐ray performed in the operating room at the end of surgery when patients are still under general anesthesia in the supine position 9,10 .…”

“…A second chest X-ray is also performed, usually 1 week after surgery, before the patient is discharged home. 7,8 The present study focuses on the first chest X-ray performed in the operating room at the end of surgery when patients are still under general anesthesia in the supine position. 9,10 The sensitivity of lung ultrasound for pneumothorax is approximately 80%-90%, compared with just 40%-50% for a chest X-ray.…”

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

“…Thirty-eight studies reported chest X-rays to be low-value, while four studies reported on low-value use of chest CT [ 78 – 117 ]. Of these, eighteen reported on chest X-rays in follow-up after procedures known to cause pneumothorax, where the X-ray did not change management in patients without symptoms [ 94 – 112 ]. Further, routine chest X-ray was found to not change patient management when used as a pre and post op screening, at hospital admission, in medical check-ups, or in staging of cervical and breast cancer.…”