Lung Cancer: Postoperative Imaging and Complications

Unveiling the Effects of the COVID-19 Pandemic on Lung Cancer Surgery

The aim of this study is to investigate the impact of the COVID-19 pandemic on the surgical treatment of lung cancer patients. Data from patients who underwent surgery during the pandemic were analyzed and compared to pre-pandemic and post-pandemic periods. Multiple parameters were examined, and their changes yielded significant results compared to other periods of the study. The statistical analysis revealed a significant decrease in the number of surgical interventions during the pandemic (p < 0.001), followed by a significant rebound thereafter. During this period, there was a significant increase in the T stage of cancer compared to both pre-pandemic and post-pandemic periods (p = 0.027). Additionally, the mean Charlson comorbidity index score was significantly higher during the pandemic compared to the pre-pandemic period (p = 0.042). In this crisis period, a significant decrease was recorded in both the total hospitalization duration (p = 0.015) and the pre-operative hospitalization duration (p = 0.006). These findings provide evidence of significant changes in clinical and therapeutic strategies applied to lung cancer surgery patients during the study period. The pandemic has had a substantial and complex impact, the full extent of which remains to be fully understood.

Pearls and Pitfalls in Postsurgical Imaging of the Chest

A variety of surgical procedures are utilized to treat a spectrum of cardiopulmonary diseases. In the imaging of patients in the post-operative period, it is important to have an understanding of surgical techniques including invasive and minimally invasive procedures and the expected postsurgical findings. Knowledge of certain patient risk factors, various complications associated with specific surgical procedures, and a keen attention to detail are essential to avoid misinterpretation and delay diagnosis. Prompt detection of potential complications allows timely intervention, thereby, optimizing patient outcomes in the post-operative period.

The postoperative chest in lung cancer

Most of the complications following lung cancer surgery occur in the early postoperative period and can result in significant morbidity and mortality. Delayed complications can also occur. Diagnosing these complications can be challenging because clinical manifestations are non-specific. Imaging plays an important role in detecting these complications in a timely manner and facilitates prompt interventions. Hence, it is important to have knowledge of the expected anatomical alterations following lung cancer surgeries, and the spectrum of post-surgical complications and their respective imaging findings to avoid misinterpretations or delay in diagnosis.

Herniation of Packing Material into a Bronchopleural Fistula after Right Pneumonectomy and Clagett Window

Diagnosis of a bronchopleural fistula (BPF) can be challenging in patients after pneumonectomy and Clagett window. Herein, we present a case of pneumonectomy for advanced lung cancer complicated by a BPF. Herniation of packing material from the open-chest cavity into the fistula and airways on computed tomography was an important clue to making the diagnosis.