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A Journal on Surgery

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Chirurgia 2000 February;13(1):23-8

language: Italian

Role of routine preoperative chest X-ray in patients candidate to laparoscopic surgery. Results of a prospective study

Silecchia G. 1, Polito D. 2, Raparelli L. 1, Elmore U. 1, Greco F. 1, Nasorri L. 1, Fabiano P. 1, Basso N. 1

1 VII Patologia Chirurgica, Istituto II Clinica Chirurgica, Università degli Studi "La Sapienza", Roma;
2 Divisione di Chirurgia, Policlinico Umberto I°, Ospedale di Zagarolo, ASL RM G, Roma


Background. The aim of the present study was to evaluate the clinical usefulness and the costs/benefits of routine preoperative X-ray of the chest, in patients candidate to elective laparoscopic surgery.
Methods. 1157 patients with benign diseases were enrolled in the study, classified in 4 groups on the basis of cardiopulmonary risks and the undergone to laparoscopic surgery.
Results. The preoperative studies (X-rays and questionnaire) results were: in 51 patients (4.4%) there was a pathologic finding on X-rays, in 22 of them the results were unexpected. Anesthesia was not changed in any case, while the surgical approach was modified from laparoscopy to laparotomy in one case.
Conclusions. Chest X-ray is not able to detect pathologic conditions requiring a changing of the anesthetic and/or surgical procedures better than the history and the examination of the patients. Since preoperative X-rays are an emission source of radiations and an element of cost, a definition of a guideline for clinical use is needed. The conclusion is drawn that routine preoperative chest X-ray, is of little use in absence of risk factors.

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