Evaluation of Thoracic Ultrasound in Monitoring Pleural Drainage in Postoperative Thoracic Surgery

Thoracic drainage is a common and almost systematic practice after thoracic surgery requiring daily management and monitoring until and after its removal. It allows, after opening the pleura, the evacuation of liquid and/or air retained in the pleural cavity. The overall monitoring of the patient after thoracic surgery is based on clinical vigilance combined with thoracic imaging, in particular the chest X-ray which remains the Gold Standard (reference examination). The removal of the drain is decided according to the quantity and appearance of the evacuated fluid, the persistence of air leaks, etc… A few hours after the removal of the drain, it is routine to perform a chest X-ray before authorizing a possible discharge from the department. This practice does not correspond to an established scientific protocol but is systematically performed in our department before discharge. Several studies have defended the place of ultrasound in thoracic imaging and its contribution to the detection of postoperative and intensive care complications. Unlike radiography, this technique is non-irradiating, less expensive and more readily available. It allows the detection of pneumothorax, pleural effusions and other complications detectable on X-ray. To our knowledge, the contribution of thoracic ultrasound has not been studied in the decision to authorize the discharge of the patient after removal of the thoracic drain.