TY - JOUR
T1 - Postlobectomy chest radiographic changes
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
Y1 - 2011/11
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.
KW - Lobectomy
KW - Plain radiograph
KW - Quantitative analysis
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U2 - 10.1016/j.carj.2010.12.005
DO - 10.1016/j.carj.2010.12.005
M3 - Article
C2 - 21958743
AN - SCOPUS:80054821267
SN - 0846-5371
VL - 62
SP - 280
EP - 287
JO - Canadian Association of Radiologists Journal
JF - Canadian Association of Radiologists Journal
IS - 4
ER -