Imaging findings of complications after thoracic surgery

  • Yeo Ryang Kang
  • Jeung Sook Kim
  • Yoon Ki Cha
  • Yeon Joo Jeong


Many surgical procedures are used for the treatment of lung, heart, and mediastinal diseases. The techniques can result in postoperative complications. The nature of these complications differs according to the duration of thoracic surgery and the onset of the complication. The complications occurring within 1 month and more than 1 month generally considered as early and late complications, respectively. Chest radiographs and CT scans obtained in patients who have undergone thoracic surgery show normal changes during the surgical procedure and diverse postsurgical complications. Familiarity with the clinical and radiologic findings of the normal alterations and possible complications after thoracic surgery is crucial in minimizing the increased morbidity and mortality.


Postoperative complications Lung Mediastinum Multidetector computed tomography 



There were no financial sponsors for this submitted manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Kim EA, Lee KS, Shim YM, Kim JG, Kim KM, Kim TS, et al. Radiographic and CT findings in complications following pulmonary resection. Radiographics. 2002;22:67–866.CrossRefGoogle Scholar
  2. 2.
    Chae EJ, Seo JB, Kim SY, Do KH, Heo JN, Lee JS, et al. Radiographic and CT findings of thoracic complications after pneumonectomy. Radiographics. 2006;26:1449–677.CrossRefGoogle Scholar
  3. 3.
    Chandrashekhara SH, Bhalla AS, Sharma R, Gupta AK, Kumar A, Arora R. Imaging in postpneumonectomy complications: a pictorial review. J Cancer Res Ther. 2011;7(1):3–10.CrossRefGoogle Scholar
  4. 4.
    Leung AN, Muller NL, Miller RR. CT in differential diagnosis of diffuse pleural disease. AJR. 1990;154:487–92.CrossRefGoogle Scholar
  5. 5.
    Müller NL, Fraser RS, Colman NC, Paré PD. Radiologic diagnosis of diseases of the chest. Philadelphia: Saunders; 2001. p. 614–624.Google Scholar
  6. 6.
    Kushibe K, Takahama M, Tojo T, Kawaguchi T, Kimura M, Taniguchi S. Assessment of pulmonary function after lobectomy for lung cancer—upper lobectomy might have the same effect as lung volume reduction surgery. Eur J Cardiothorac Surg. 2006;29(6):886–90.CrossRefGoogle Scholar
  7. 7.
    Li E, Fishman EK. Evaluation of complications after sternotomy using single- and multidetector CT with three-dimensional volume rendering. AJR. 2003;181:1065–70.CrossRefGoogle Scholar
  8. 8.
    Restrepo CS, Martinez S, Lemos DF, Washington L, McAdams HP, Vargas D, et al. Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 2009;29:839–59.CrossRefGoogle Scholar
  9. 9.
    Sihoe AD. The evolution of minimally invasive thoracic surgery: implications for the practice of uniportal thoracoscopic surgery. J Thorac Dis. 2014;6(Suppl 6):S604–S617617.Google Scholar
  10. 10.
    Fu SJ, Ho VP, Ginsberg J, Perry Y, Delaney CP, Linden PA, et al. Complications, not minimally invasive surgical technique, are associated with increased cost after esophagectomy. Minim Invasive Surg. 2016;2016:7690632.Google Scholar
  11. 11.
    Bao F, Zhang C, Yang Y, He Z, Wang L, Hu J. Comparison of robotic and video-assisted thoracic surgery for lung cancer: a propensity-matched analysis. J Thorac Dis. 2016;8(7):1798–803.CrossRefGoogle Scholar
  12. 12.
    Kocher GJ. Robotic-assisted thoracoscopic surgery: state of the art and future perspectives. J Thorac Dis. 2017;9(7):1855–7.CrossRefGoogle Scholar
  13. 13.
    Rotman JA, Plodkowski AJ, Hayes SA, de Groot PM, Shepard JA, Munden RF, et al. Postoperative complications after thoracic surgery for lung cancer. Clin Imaging. 2015;39(5):735–49.CrossRefGoogle Scholar
  14. 14.
    Pool KL, Munden RF, Vaporciyan A, O'Sullivan PJ. Radiographic imaging features of thoracic complications after pneumonectomy in oncologic patients. Eur J Radiol. 2012;81(1):165–72.CrossRefGoogle Scholar
  15. 15.
    Zompatori M, Ciccarese F, Fasano L. Overview of current lung imaging in acute respiratory distress syndrome. Eur Respir Rev. 2014;23(134):519–30.CrossRefGoogle Scholar
  16. 16.
    Chung SH, Nam JE, Choe KO, Choi BW, Hur J, Lee HJ, et al. Radiologic findings of lung lobe torsion in reconstructed multidetector computed tomography image lead to early detection. Clin Imaging. 2010;34(5):400–3.CrossRefGoogle Scholar
  17. 17.
    Chaaya G, Vishnubhotla P. Pulmonary vein thrombosis: a recent systematic review. Cureus. 2017;9(1):e993.Google Scholar
  18. 18.
    Ohtaka K, Hida Y, Kaga K, Takahashi Y, Kawase H, Hayama S, et al. Left upper lobectomy can be a risk factor for thrombosis in the pulmonary vein stump. J Cardiothorac Surg. 2014;9(5):1–5.Google Scholar
  19. 19.
    Hassani C, Saremi F. Comprehensive cross-sectional imaging of the pulmonary veins. Radiographics. 2017;37(7):1928–54.CrossRefGoogle Scholar
  20. 20.
    Choe DH, Lee JH, Lee BH, Kim KH, Chin SY, Zo JI. Postpneumonectomy empyema. CT findings in six patients. Clin Imaging. 2001;25(1):28–31.CrossRefGoogle Scholar
  21. 21.
    Exarhos DN, Malagari K, Tsatalou EG, Benakis SV, Peppas C, Kotanidou A, et al. Acute mediastinitis: spectrum of computed tomography findings. Eur Radiol. 2005;15(8):1569–74.CrossRefGoogle Scholar
  22. 22.
    Katabathina VS, Restrepo CS, Martinez-Jimenez S, Riascos RF. Nonvascular, nontraumatic mediastinal emergencies in adults: a comprehensive review of imaging findings. Radiographics. 2011;31:1141–60.CrossRefGoogle Scholar
  23. 23.
    Juhl AA, Hody S, Videbaek TS, Damsgaard TE, Nielsen PH. Deep sternal wound infection after open-heart surgery: a 13-year single institution analysis. Ann Thorac Cardiovasc Surg. 2017;23(2):76–82.CrossRefGoogle Scholar
  24. 24.
    Cotogni P, Barbero C, Rinaldi M. Deep sternal wound infection after cardiac surgery: evidences and controversies. World J Crit Care Med. 2015;4(4):265–73.CrossRefGoogle Scholar
  25. 25.
    Joseph L, Jeanmonod RK. Delayed presentation of deep sternal wound infection. West J Emerg Med. 2014;15(2):134–6.CrossRefGoogle Scholar
  26. 26.
    Alpert JB, Godoy MC, Degroot PM, Truong MT, Ko JP. Imaging the post-thoracotomy patient: anatomic changes and postoperative complications. Radiol Clin N Am. 2014;52(1):85–103.CrossRefGoogle Scholar
  27. 27.
    Shen KR, Wain JC, Wright CD, Grillo HC, Mathisen DJ. Postpneumonectomy syndrome: surgical management and long-term results. J Thorac Cardiovasc Surg. 2008;135(6):1210–6 (discussion 6–9).CrossRefGoogle Scholar
  28. 28.
    Koike T, Koike T, Yoshiya K, Tsuchida M, Toyabe S. Risk factor analysis of locoregional recurrence after sublobar resection in patients with clinical stage IA non-small cell lung cancer. J Thorac Cardiovasc Surg. 2013;146(2):372–8.CrossRefGoogle Scholar
  29. 29.
    Dov W, Yael R. Hernia of the lung. Ann Thorac Surg. 2002;74:1963–6.CrossRefGoogle Scholar
  30. 30.
    Santini M, Fiorello A, Vicidomini G, Busiello L. Pulmonary hernia secondary to limited access for mitral valve surgery and repaired by video thoracoscopic surgery. Interact Cardiovasc Thorac Surg. 2009;8(1):111–3.CrossRefGoogle Scholar

Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  • Yeo Ryang Kang
    • 1
  • Jeung Sook Kim
    • 1
  • Yoon Ki Cha
    • 1
  • Yeon Joo Jeong
    • 2
  1. 1.Department of RadiologyDongguk University Ilsan Hospital, Dongguk University School of MedicineGoyang-siSouth Korea
  2. 2.Department of RadiologyPusan National University Hospital, Pusan National University School of MedicinePusanSouth Korea

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