Is radiographic evaluation of the chest necessary following flank surgery?

Abstract

We determined whether routine postoperative chest radiography is warranted after flank surgery to assess for pneumothorax. A retrospective study of 253 adult flank operations performed during a 6-year period was conducted. Incidental pleurotomy occurred in 63 cases (24.9%). The performance of rib resection and the level of rib removed as well as female gender had a significant impact on this occurrence. Pleurotomy was treated by a simple evacuation technique and tube thoracostomy was not necessary. Only 2 patients (0.8%) had a postoperative pneumothorax without intraoperative recognition of pleurotomy, which resolved without intervention. Routine postoperative chest radiography to assess for pneumothorax following open flank surgery is not necessary.