Routine Immediate Postoperative Chest Radiography After Minimally Invasive Pulmonary Lobectomy Has a Low Impact on Clinical Management: A Value-Based Imaging Analysis

The clinical benefit of routine chest X-rays performed immediately after minimally inva- sive pulmonary lobectomy, even in asymptomatic patients, is uncertain. We reviewed 554 patients who underwent video-assisted thoracoscopic lobectomy to assess whether routine X-rays in the recovery room changed management. Only 12 out of 554 (2.2%) led to any change in patient care; 1 patient required reoperation; 5 required chest tube reinsertions based on an X-ray finding without symptoms. Conversely, X-rays after chest tube removal more often led to clinical decisions. These findings support the consideration of a selective, symptom-driven imaging strategy in appropriately selected asymptomatic patients, although prospective validation is required.