Clinical Value of Routine Chest Radiography and Point-of-Care Lung Ultrasound Following Ambulatory Thoracic Sympathectomy

The goal of this observational study is to find out whether routine chest X-rays after surgery actually change patient care, and whether lung ultrasound could be a suitable alternative for detecting important postoperative findings in adults undergoing same-day bilateral thoracic sympathectomy for primary hyperhidrosis or facial flushing. The main questions it aims to answer are: How often does a routine postoperative chest X-ray change clinical management? Can lung ultrasound detect relevant postoperative findings as effectively as chest X-ray? Researchers will compare lung ultrasound results and the treatment decision that would have been made based on ultrasound alone with the actual treatment decision based on chest X-ray to see if using lung ultrasound first, with chest X-ray only when needed, could reduce radiation exposure and imaging costs without affecting care. Participants will: Have a routine chest X-ray after surgery. Have a lung ultrasound exam in the recovery unit before the chest X-ray result is known. Have their postoperative care recorded based on the actual chest X-ray result. Be monitored for short-term outcomes after discharge.

Inclusion criteria * Adults aged 18 years or older with a scheduled bilateral thoracic sympathectomy for primary hyperhidrosis or facial flushing. * Same-day discharge surgery planned. * Signed informed consent. Exclusion criteria * Previous ipsilateral or bilateral thoracic surgery. * Chest wall deformity Post-inclusion elimination criteria * Intraoperative conversion. * Complication requiring hospitalization. * Technically non-interpretable ultrasound examination in both hemithoraces.