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Updated: Aug 28, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Are Routine Chest X-rays Necessary following Thoracic Surgery? A Systematic Literature Review and Meta-Analysis.

Christian Galata1, Lorena Cascant Ortolano2, Saeed Shafiei1

  • 1Division of Thoracic Surgery, Academic Thoracic Center Mainz, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55122 Mainz, Germany.

Cancers
|September 23, 2022
PubMed
Summary

Routine chest X-rays after thoracic surgery rarely change patient care. Post-drain removal X-rays are more beneficial, altering care in 7.30% of cases.

Keywords:
X-raylobectomylung surgeryperioperative carethoracic surgery

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Area of Science:

  • Thoracic Surgery
  • Diagnostic Imaging
  • Evidence-Based Medicine

Background:

  • Variability in perioperative chest X-ray (CXR) frequency in thoracic surgery.
  • Practices range from daily CXRs to imaging only when clinically indicated.

Purpose of the Study:

  • To evaluate the evidence for perioperative CXRs in thoracic surgery.
  • To determine the clinical value of CXRs by assessing changes in patient care.

Main Methods:

  • Systematic literature review conducted up to November 2021.
  • Included studies reporting CXR outcomes in adult patients undergoing general thoracic surgery.

Main Results:

  • 11 studies with 3841 patients and 4784 CXRs were analyzed.
  • CXR led to changes in patient care in 10.74% of cases (488/4784).
  • Postoperative CXRs in mediastinoscopic lymphadenectomy or thoracoscopic sympathectomy never altered patient care.

Conclusions:

  • No evidence supports routine pre-operative or daily postoperative CXRs.
  • Immediate postoperative CXRs seldom impact patient management.
  • CXR after drain removal is likely reasonable, changing care in 7.30% of instances.