The use of ultrasound in the evaluation of postoperative pneumothorax and lung re-expansion in patients after lung resection.

Many clinical studies have shown ultrasonography (US) is useful for the diagnosis of different abnormalities involving pleura; chest ultrasound (CUS) is widely used to detect pneumothorax in patients, but there is no data on its use for the follow-up of lung re-expansion after lung resection. We performed a unicentric observational study all patients between January 2018 and May 2021 undergoing lobectomy in which lung re-expansion was assessed daily with chest ultrasound (CUS) and chest radiography (CXR) until chest drainage was removed. Ultarsound clinical signs indicating a pneumothorax were: the detection of a positive lung point, absence of sliding or a consistent stratosphere sign with an absence of lung pulse, B-lines, I-lines or consolidations. Sensitivity, specificity, PPV, NPV of CUS and CXR were, respectively: 86% vs. 98% (p = 0.002); 100% vs. 100% (p = 1.0); 94% vs. 75% (p = 0.231); and 94% vs. 99% (p = 0.7). Ultrasound is a method available also to the patient's bed, an easy-to-learn technique even for inexperienced operators, therefore it is a valuable tool for checking the post-lobectomy lung expansion, reduce the use of chest radiography. Chest ultrasound, Chest radiography, Pneumothorax. L’ecografia del torace è ampiamente usata per riscontrare lo pneumotorace, ma non vi sono dati sui controlli della successiva riespansione del polmone dopo interventi di resezione. Abbiamo fatto uno studio osservazionale unicentrico della nostra casistica raccolta dal gennaio 2018 a maggio 2019 dopo lobectomia, con controllo quotidiano mediante l’ecografia toracica e radiografie del torace fino alla rimozione del drenaggio pleurico. La sensibilità, specificità, PPV, NPV dell’ecografia e della radiografia del torace sono state rispettivamente 86% vs. 98% (p = 0.002); 100% vs. 100% (p = 1.0); 100% vs. 100% (p = 1.0); 94% vs. 75% (p = 0.231); and 94% vs. 99% (p = 0.7). In coclusione l’ecografia risulta essere un metodo affidabile anche dei pazienti a letto, ed una tecnica di facile apprendimento anche per operatori poco esperti, quindi valido per i controlli dell’espansione polmonare dopo lobectomia, riducendo la necessità dell’uso delle radiografie ripetute del torace.