Razuk Filho Mauro, Minamoto Fabio Eiti Nishibe, Mariani Alessandro Wasum, D'Ambrosio Paula Duarte, Rodrigues Thiago Potrich, Chammas Maria Cristina, Terra Ricardo Mingarini, Pêgo-Fernandes Paulo Manuel
Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Clinics (Sao Paulo). 2024 Aug 6;79:100452. doi: 10.1016/j.clinsp.2024.100452. eCollection 2024.
This study aims to evaluate the role of TUSG in the postoperative period and the detection of early complications after surgical treatment, pulmonary resection, or decortication for infectious and inflammatory thoracic diseases, comparing with the standard method (Chest Radiography ‒ CXR).
Prospective non-randomized self-controlled study. Twenty-one patients over 16 years of age have undergone surgical treatment of inflammatory and infectious lung diseases. These patients were followed up with CXR and TUSG (performed on the 1 and 3 postoperative days and/or after the chest tube removal).
Both exams demonstrated similar results regarding their ability to safely predict the adequate moment for chest drain removal. TUSG allowed chest drain removal in 30% of cases and CXR in 34%. Statistical analysis demonstrates that both exams have similar capabilities in detecting postoperative changes in the pleural space. However, the authors report that TUSG is statistically more accurate in detecting subcutaneous emphysema than CXR (p = 0.037, Kappa [κ = 0.3068]). The analysis of other parameters showed no statistical difference.
The authors conclude that TUSG in trained hands is equivalent to CXR in searching for postoperative complications regarding the surgical treatment of infectious and inflammatory thoracic diseases and can be used as a complement, and not a substitute, to CXR, when CCT is not feasible, or a more urgent diagnosis is needed.
本研究旨在评估超声引导胸段置管引流（TUSG）在术后阶段的作用以及在感染性和炎性胸部疾病手术治疗（肺切除或纤维板剥脱术）后早期并发症的检测情况，并与标准方法（胸部X线摄影 - CXR）进行比较。
前瞻性非随机自身对照研究。21例16岁以上患者接受了炎性和感染性肺部疾病的手术治疗。对这些患者进行CXR和TUSG随访（在术后第1天和第3天及/或拔除胸管后进行）。
在安全预测拔除胸管的合适时机方面，两种检查显示出相似的结果。TUSG使30%的病例能够拔除胸管，CXR使34%的病例能够拔除胸管。统计分析表明，两种检查在检测胸膜腔术后变化方面具有相似的能力。然而，作者报告称，在检测皮下气肿方面，TUSG在统计学上比CXR更准确（p = 0.037，Kappa[κ = 0.3068]）。对其他参数的分析未显示统计学差异。
作者得出结论，对于感染性和炎性胸部疾病的手术治疗，在有经验的医生操作下，TUSG在寻找术后并发症方面与CXR相当，并且在计算机断层扫描（CCT）不可行或需要更紧急诊断时，可作为CXR 的补充而非替代方法使用。
