Abdominal Placement of Tube Thoracostomy Due to Lack of Recognition of Paralysis of Hemidiaphragm

Foresti, Valeriano; Villa, Alejandra; Casati, O; Parisio, Eva Maria; Filippi, G. De

doi:10.1378/chest.102.1.292

Cited by 19 publications

(9 citation statements)

References 10 publications

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“…Inadequate air or fluid drainage, drain malposition, intraabdominal drain placement, parenchymal lung injury, diffuse subcutaneous emphysema can be observed in patients who have undergone CTT. In addition to these, complications such as pulmonary infarction secondary to internal mammarian artery erosion, esophagus perforation, gastric perforation, pulmonary artery or intercostal artery injuries, cardiogenic shock due to right ventricular compression have been defined in several studies [4][5][6][7][8][9][10]. The most serious complications are related to the drain placement techniques [1,11,12].…”

Section: Discussionmentioning

confidence: 99%

The Analysis of the Chest Tube Thoracostomies Performed in a Newly Established Hospital of a Medical School

Alar¹,

Gedik²

2015

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışma ile kliniğimizde uygulanan tüp torakostomi (TT) işlemleri-nin sonuçları araştırılmıştır. Gereç ve Yöntem: Aralık 2009 -Temmuz 2013 arasında Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Kliniği tarafından TT uygulanan 130 hastanın kayıtları retrospektif olarak incelendi. Bulgular: TT uygulanan 130 hastanın 102'si erkek (%78) 28' i (%22) kadındı. Hastaların ortalama yaşı 58.9±20.4 yıldı. Hastaların %19' unu (n:25) Göğüs Cerrahisi servisinin hastaları oluştururken %81' ini (n:105) dış servislerden tarafımıza konsülte edilen hastalar oluşturmaktaydı. TT endikasyonları arasında en sık rastlanan neden plevral efüzyondu (34,6%, n:45). Çeşitli nedenlerle plevral efüzyonu olan hastaların (%63, n:84) ortalama drenaj miktarı 1462.80±1054.46 ml olarak bulundu. Çeşitli nedenlerle pnömotoraks olan hastaların (%37, n:46) ortalama hava drenaj süresi 5.8±3.1 gün olarak bulundu. Kliniğimizde TT uygulanan 130 hastanın sadece bir tanesinde komplikasyon gelişti (%0,8). Bu komplikasyonda intraparankimal dren konulması idi. Tartışma: Genellikle acil koşullarda uygulanmak zorunda kalınan bu cerrahi girişimin potansiyel birçok ciddi komplikasyonunun da olması Göğüs Cerrahisi kliniklerindeki asistan eğitiminin önemini arttırmaktadır. Doğru endikasyonda, doğru yerden, cerrahi prensiplere uygun olarak takılan ve komplikasyon oranları çok düşük olan TT, Göğüs Cerrahlarının bulundukları hastanedeki önemini daha da arttıran ve diğer klinikler ile ilişkilerini geliştirmede önemli rol oynayan cerrahi bir işlemdir. Anahtar KelimelerTorakostomi; Pnömotoraks; Plevral Efüzyon; Komplikasyon Abstract Aim: We have analyzed the chest tube thoracostomies (CTT) performed in our Thoracic Surgery clinics of our newly established medical school hospital. Material and Method: The medical records of 130 patients to whom CTT were performed by the Thoracic Surgery Clinics of the Çanakkale Onsekiz Mart University from December 2009 to July 2013 were retrospectively analyzed. Results: 102 patients (78%) out of 130 were male and 28 (22%) were women. Mean age of the patients were 58.9±20.4. 19% (n:25) of these patients were diagnosed at our clinics and the remaining 81% (n:105) were consultated from other clinics The most common indication of CTT was pleural effusion (35%, n:45). The mean fluid drainage of the patients with pleural effusions for various reasons (63%, n:84) were 1462.80±1054.46. The mean air drainage time for the patients with pneumothorax for various reasons (37%, n:46) were 5.8±3.1 days. There was only one complication (0,8%) in these 130 patients which was the intraparanchymal drain placement. Discussion: As a procedure that is usually performed under emergency conditions CTT has a high potential for development of serious complications and thus increasing the importance of resident doctor training in Thoracic Surgery clinics. CTT has a low rate of complications when performed with the right indication, at the appropriate location and in devotion to the surgical principles; can increase the importance of ...

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Section: Discussionmentioning

confidence: 99%

The Analysis of the Chest Tube Thoracostomies Performed in a Newly Established Hospital of a Medical School

Alar¹,

Gedik²

2015

Ann Clin Anal Med

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“…The current recommendation is to achieve a position in what was described as the "safe triangle" which encompasses the 3 rd through 5 th intercostal spaces [6]. Such placement is thought to decrease various complications associated with lateral tube placement including pulmonic perforation [7] cardiac perforation [8][9][10] neurovascular injury [11][12][13] intra-abdominal placement and diaphragmatic injury [14][15][16][17][18]. The latter two complications are of particular concern with lower tube placement due to the proximity of the diaphragm and abdominal cavity to the lower intercostal spaces.…”

Section: Discussionmentioning

confidence: 99%

Lateral Thoracostomy Tubes: Is Outcome Affected by Level of Intercostal Space?

M¹

2014

J Trauma Treat

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“…There are a variety of tube thoracostomy complications that can be divided into two groups: (i) due to inadequate function, and (ii) due to intrathoracic or intraabdominal viscera injury or chest wall structure injury. Perforation of the oesophagus, stomach, pulmonary artery, right atrium, injury of the intercostals vessels and cardiogenic shock due to the chest tube compression of the right ventricle have been reported [4][5][6][7][8][9]. One study described a 30% misplacement rate for chest tubes in critically ill patients [10].…”

Section: Discussionmentioning

confidence: 99%