Lung ultrasonography to assess pulmonary complications after head and neck cancer surgery.
Ling Gao, Likuan Wang, Xudong Yang et al.
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In 30 seconds
This randomized controlled trial assessed whether daily lung ultrasonography (LUS), added to clinical evaluation with chest X-ray when indicated, improves detection of postoperative pulmonary complications (PPCs). It enrolled 196 adults at intermediate or high risk undergoing head and neck cancer surgery with free-flap reconstruction. The routine LUS strategy detected more clinically relevant PPCs than the current strategy (92.3% vs. 66.7%, p = 0.035), with higher diagnostic accuracy and earlier detection. Hospital stay and mortality did not differ significantly between groups.
Key findings
- Clinically relevant PPC detection was 92.3% with daily LUS plus usual assessment versus 66.7% with usual assessment alone (p = 0.035).
- Diagnostic accuracy was higher with the routine LUS strategy (AUC: 91.9% vs. 80.4%, p = 0.035).
- PPCs were detected earlier with routine LUS: median postoperative day 2 versus 3 (p = 0.042).
- Hospital stay and mortality showed no significant differences between strategies.
Why it matters
PPCs are common after major head and neck cancer surgery, and earlier recognition may inform postoperative assessment. This trial suggests that adding daily bedside LUS can improve detection compared with clinical evaluation and on-demand chest X-ray, while showing no significant short-term outcome differences.
What to keep in mind
The trial included adults at intermediate or high PPC risk undergoing head and neck cancer surgery with free-flap reconstruction; applicability to other surgical populations is uncertain. No significant differences in hospital stay or mortality were observed.