Can Chest Ultrasound Replace Chest X-ray in Thoracic Surgery?

Background: There is growing evidence that supports the use of chest ultrasound (CUS) versus conventional chest X-ray (CXR) in order to diagnose postoperative complications. However, data regarding its use after thoracic surgery are scarce and contradictory. The aim of this study was to conduct a systematic review to evaluate the accuracy of CUS after thoracic surgery. Methods: An electronic search in MEDLINE (via PubMed), complemented by manual searches in article references, was conducted to identify eligible studies. Results: Six studies with a total of 789 patients were included in this meta-analysis. Performing CXR decreased in up to 61.6% of cases, with the main reasons for performing CXR being massive subcutaneous emphysema or complex hydrothorax. Agreement between CUS and routine-based therapeutic options was, in some studies, up to 97%. Conclusions: The selectively postoperative use of CUS may reduce the number of routinely performed CXR. However, if CUS findings are inconclusive, further radiological examinations are obligatory.