Utility of Immediate Postlobectomy Fiberoptic Bronchoscopy in Preventing Atelectasis

doi:10.1378/chest.94.1.38

Chest

Volume 94, Issue 1, July 1988, Pages 38-43

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In a prospective randomized trial, we examined the value of routine postlobectomy fiberoptic bronchoscopy (FOB) in preventing postoperative atelectasis. Twenty patients who underwent lobectomy were randomly assigned to either chest physical therapy alone (group 1) or immediate bronchoscopy (group 2). Both group I and group 2 were placed on a standard physical therapy regimen consisting of aerosol bronchodilator therapy, chest percussion, and incentive spirometry. It was concluded that routine postlobectomy bronchoscopy offers no advantage over the usual physical therapy measures in preventing the development of postoperative atelectasis.

Section snippets

Materials and Methods

Twenty consecutive patients undergoing lobectomy between September 1985 and September 1986, at Albert Einstein Medical Center in Philadelphia, were randomly allocated to two groups.

Each group consisted of ten patients who received a standard postoperative physical therapy regimen, consisting of percussion maneuvers to both the operative side and the contralateral chest as well. These maneuvers consisted of postural drainage for 15 to 20 minutes, five minutes of percussion to the operative side,

Results

The mean age of group 1 was 57 (range 36 to 83) and in group 2 was 64 (range 40 to 78) (Table 1). The difference was not statistically significant. There was no difference in baseline arterial blood gas values, FVC or FEV₁ between either group (Table 2).

Discussion

This study attempted to answer the question as to whether or not immediate postoperative FOB could decrease the incidence of atelectasis in a population who were well-known to be at risk for this complication.6, 7, 8 At our institution, patients undergoing lobectomies appear to have a higher incidence of atelectasis, as compared to pneumonectomy patients, presumably as a result of mechanical forces exerted at the time of resection, or of accidental endobronchial soilage. To answer this

ACKNOWLEDGMENT

The authors thank Janice Peters for typing the manuscript, Lori Goldstein for assistance with graphics, the Department of Surgery, Albert Einstein Medical Center, and Peg Kleinfeld for coordinating physical therapy treatments.

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Chest

Clinical InvestigationsUtility of Immediate Postlobectomy Fiberoptic Bronchoscopy in Preventing Atelectasis

Section snippets

Materials and Methods

Results

Discussion

ACKNOWLEDGMENT

Chest

Chest

Chest

Chest

Ann Thorac Surg

Chest

Chest

Chest

Chest

Chest

Ann Thorac Surg

Chest

State of the art—preoperative evaluation of pulmonary function validity, indications and benefits

Am Rev Respir Dis

Effect of morphine on pattern of breathing: a possible factor in the etiology of atelectasis

JAMA

The arterial/alveolar oxygen tension ratio: an index of gas exchange applicable to varying inspired oxygen concentrations

Am Rev Respir Dis

Lobar collapse in the surgical intensive care unit

Br J Radiol

Clinical Investigations
Utility of Immediate Postlobectomy Fiberoptic Bronchoscopy in Preventing Atelectasis