Postlobectomy chest radiographic changes: A quantitative analysis

Choo Won Kim, Alla Godelman, Vineet R. Jain, Avraham Merav, Linda B. Haramati

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To provide a quantative analysis of postlobectomy chest radiographic changes and to evaluate whether the scarring from prior sternotomy affects the size of the hemithorax and the duration of air leak in patients with subsequent lobectomy. Methods: In this retrospective case-controlled series, 10 consecutive patients who had a lobectomy after a prior sternotomy and 30 controls, 3 for each case, matched for lobectomy site were identified. Pre- and postoperative chest radiographs were quantitatively analysed for diaphragmic elevation, size of each hemithorax, mediastinal shift, and the presence of pneumothorax. Charts were reviewed for air-leak duration, surgical complications, and duration of hospitalization. Results: There was no difference between patients with lobectomy and with and without prior sternotomy for the following variables expressed as mean (SD): hemidiaphragm elevation (1.5 ± 2.5 vs 0.5 ± 2.0 cm; P =.2), change of hemithorax size (mean transverse, 0.99 ± 0.05 vs 0.97 ± 0.07; P =.5; craniocaudal, 0.93 ± 0.08 vs 0.91 ± 0.08; P =.4) and mediastinal shift (upper, 1.2 ± 0.4 vs 1.3 ± 0.6; P =.5; lower, 1.2 ± 0.4 vs 1.2 ± 0.3; P =.8), the latter 2 were expressed as the ratio of post- to preoperative measurements. These postlobectomy radiographic findings varied, depending on the resected lobe, and became progressively more pronounced during the first 12 months after surgery. There was no difference in pneumothorax duration (mean [SD]) (9.5 ± 21 days vs 6.4 ± 7.5 days; P =.5), air leak duration (mean [SD]) (0.7 ± 0.8 days vs 1.3 ± 3.9 days; P =.6), complication rate (20% vs 30%; P = .5), or hospital stay (mean [SD]) (6.0 ± 1.7 days vs 6.9 ± 4.7 days; P =.6). Conclusion: There are specific patterns of volume loss, mediastinal shift, and hemidiaphragm displacement that can be quantified on postlobectomy chest radiographs. Prior sternotomy did not affect postlobectomy radiographic changes or patient outcome.

Original languageEnglish (US)
Pages (from-to)280-287
Number of pages8
JournalCanadian Association of Radiologists Journal
Volume62
Issue number4
DOIs
StatePublished - Nov 2011

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Sternotomy
Thorax
Air
Pneumothorax
Cicatrix
Length of Stay
Hospitalization

Keywords

  • Lobectomy
  • Plain radiograph
  • Quantitative analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Postlobectomy chest radiographic changes : A quantitative analysis. / Kim, Choo Won; Godelman, Alla; Jain, Vineet R.; Merav, Avraham; Haramati, Linda B.

In: Canadian Association of Radiologists Journal, Vol. 62, No. 4, 11.2011, p. 280-287.

Research output: Contribution to journalArticle

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abstract = "Purpose: To provide a quantative analysis of postlobectomy chest radiographic changes and to evaluate whether the scarring from prior sternotomy affects the size of the hemithorax and the duration of air leak in patients with subsequent lobectomy. Methods: In this retrospective case-controlled series, 10 consecutive patients who had a lobectomy after a prior sternotomy and 30 controls, 3 for each case, matched for lobectomy site were identified. Pre- and postoperative chest radiographs were quantitatively analysed for diaphragmic elevation, size of each hemithorax, mediastinal shift, and the presence of pneumothorax. Charts were reviewed for air-leak duration, surgical complications, and duration of hospitalization. Results: There was no difference between patients with lobectomy and with and without prior sternotomy for the following variables expressed as mean (SD): hemidiaphragm elevation (1.5 ± 2.5 vs 0.5 ± 2.0 cm; P =.2), change of hemithorax size (mean transverse, 0.99 ± 0.05 vs 0.97 ± 0.07; P =.5; craniocaudal, 0.93 ± 0.08 vs 0.91 ± 0.08; P =.4) and mediastinal shift (upper, 1.2 ± 0.4 vs 1.3 ± 0.6; P =.5; lower, 1.2 ± 0.4 vs 1.2 ± 0.3; P =.8), the latter 2 were expressed as the ratio of post- to preoperative measurements. These postlobectomy radiographic findings varied, depending on the resected lobe, and became progressively more pronounced during the first 12 months after surgery. There was no difference in pneumothorax duration (mean [SD]) (9.5 ± 21 days vs 6.4 ± 7.5 days; P =.5), air leak duration (mean [SD]) (0.7 ± 0.8 days vs 1.3 ± 3.9 days; P =.6), complication rate (20{\%} vs 30{\%}; P = .5), or hospital stay (mean [SD]) (6.0 ± 1.7 days vs 6.9 ± 4.7 days; P =.6). Conclusion: There are specific patterns of volume loss, mediastinal shift, and hemidiaphragm displacement that can be quantified on postlobectomy chest radiographs. Prior sternotomy did not affect postlobectomy radiographic changes or patient outcome.",
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T2 - A quantitative analysis

AU - Kim, Choo Won

AU - Godelman, Alla

AU - Jain, Vineet R.

AU - Merav, Avraham

AU - Haramati, Linda B.

PY - 2011/11

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N2 - Purpose: To provide a quantative analysis of postlobectomy chest radiographic changes and to evaluate whether the scarring from prior sternotomy affects the size of the hemithorax and the duration of air leak in patients with subsequent lobectomy. Methods: In this retrospective case-controlled series, 10 consecutive patients who had a lobectomy after a prior sternotomy and 30 controls, 3 for each case, matched for lobectomy site were identified. Pre- and postoperative chest radiographs were quantitatively analysed for diaphragmic elevation, size of each hemithorax, mediastinal shift, and the presence of pneumothorax. Charts were reviewed for air-leak duration, surgical complications, and duration of hospitalization. Results: There was no difference between patients with lobectomy and with and without prior sternotomy for the following variables expressed as mean (SD): hemidiaphragm elevation (1.5 ± 2.5 vs 0.5 ± 2.0 cm; P =.2), change of hemithorax size (mean transverse, 0.99 ± 0.05 vs 0.97 ± 0.07; P =.5; craniocaudal, 0.93 ± 0.08 vs 0.91 ± 0.08; P =.4) and mediastinal shift (upper, 1.2 ± 0.4 vs 1.3 ± 0.6; P =.5; lower, 1.2 ± 0.4 vs 1.2 ± 0.3; P =.8), the latter 2 were expressed as the ratio of post- to preoperative measurements. These postlobectomy radiographic findings varied, depending on the resected lobe, and became progressively more pronounced during the first 12 months after surgery. There was no difference in pneumothorax duration (mean [SD]) (9.5 ± 21 days vs 6.4 ± 7.5 days; P =.5), air leak duration (mean [SD]) (0.7 ± 0.8 days vs 1.3 ± 3.9 days; P =.6), complication rate (20% vs 30%; P = .5), or hospital stay (mean [SD]) (6.0 ± 1.7 days vs 6.9 ± 4.7 days; P =.6). Conclusion: There are specific patterns of volume loss, mediastinal shift, and hemidiaphragm displacement that can be quantified on postlobectomy chest radiographs. Prior sternotomy did not affect postlobectomy radiographic changes or patient outcome.

AB - Purpose: To provide a quantative analysis of postlobectomy chest radiographic changes and to evaluate whether the scarring from prior sternotomy affects the size of the hemithorax and the duration of air leak in patients with subsequent lobectomy. Methods: In this retrospective case-controlled series, 10 consecutive patients who had a lobectomy after a prior sternotomy and 30 controls, 3 for each case, matched for lobectomy site were identified. Pre- and postoperative chest radiographs were quantitatively analysed for diaphragmic elevation, size of each hemithorax, mediastinal shift, and the presence of pneumothorax. Charts were reviewed for air-leak duration, surgical complications, and duration of hospitalization. Results: There was no difference between patients with lobectomy and with and without prior sternotomy for the following variables expressed as mean (SD): hemidiaphragm elevation (1.5 ± 2.5 vs 0.5 ± 2.0 cm; P =.2), change of hemithorax size (mean transverse, 0.99 ± 0.05 vs 0.97 ± 0.07; P =.5; craniocaudal, 0.93 ± 0.08 vs 0.91 ± 0.08; P =.4) and mediastinal shift (upper, 1.2 ± 0.4 vs 1.3 ± 0.6; P =.5; lower, 1.2 ± 0.4 vs 1.2 ± 0.3; P =.8), the latter 2 were expressed as the ratio of post- to preoperative measurements. These postlobectomy radiographic findings varied, depending on the resected lobe, and became progressively more pronounced during the first 12 months after surgery. There was no difference in pneumothorax duration (mean [SD]) (9.5 ± 21 days vs 6.4 ± 7.5 days; P =.5), air leak duration (mean [SD]) (0.7 ± 0.8 days vs 1.3 ± 3.9 days; P =.6), complication rate (20% vs 30%; P = .5), or hospital stay (mean [SD]) (6.0 ± 1.7 days vs 6.9 ± 4.7 days; P =.6). Conclusion: There are specific patterns of volume loss, mediastinal shift, and hemidiaphragm displacement that can be quantified on postlobectomy chest radiographs. Prior sternotomy did not affect postlobectomy radiographic changes or patient outcome.

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