Tube Thoracostomy

Etoch, Steven W.; Barnatan, Marcos F.; Miller, Frank B.; Richardson, J. David

doi:10.1001/archsurg.1995.01430050071012

Cited by 192 publications

(43 citation statements)

References 7 publications

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“…Retained pleural collection is one of the important causes of induced infections. The origin of microbes is not only airways but also the epidermis carried by tube thoracostomies [7, 8, 13]. Adequate drainage accompanied with antibiotics should be performed.…”

Section: Discussionmentioning

confidence: 99%

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The role of repairing lung lacerations during video-assisted thoracoscopic surgery evacuations for retained haemothorax caused by blunt chest trauma

Chou

Kuo

Soo

et al. 2013

European Journal of Cardio-Thoracic Surgery

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OBJECTIVESRetained haemothorax and pneumothorax are the most common complications after blunt chest traumas. Lung lacerations derived from fractures of the ribs are usually found in these patients. Video-assisted thoracoscopic surgery (VATS) is usually used as a routine procedure in the treatment of retained pleural collections. The objective of this study was to find out if there is any advantage in adding the procedure for repairing lacerated lungs during VATS.METHODSPatients who were brought to our hospital with blunt chest trauma were enrolled into this prospective cohort study from January 2004 to December 2011. All enrolled patients had rib fractures with type III lung lacerations diagnosed by CT scans. They sustained retained pleural collections and surgical drainage was indicated. On one group, only evacuation procedure by VATS was performed. On the other group, not only evacuations but also repair of lung injuries were performed. Patients with penetrating injury or blunt injury with massive bleeding, that required emergency thoracotomy, were excluded from the study, in addition to those with cardiovascular or oesophageal injuries.RESULTSDuring the study period, 88 patients who underwent thoracoscopy were enrolled. Among them, 43 patients undergoing the simple thoracoscopic evacuation method were stratified into Group 1. The remaining 45 patients who underwent thoracoscopic evacuation combined with resection of lung lacerations were stratified into Group 2. The rates of post-traumatic infection were higher in Group 1. The durations of chest-tube drainage and ventilator usage were shorter in Group 2, as were the lengths of patient intensive care unit stay and hospital stay.CONCLUSIONSWhen compared with simple thoracoscopic evacuation methods, repair and resection of the injured lungs combined may result in better clinical outcomes in patients who sustained blunt chest injuries.

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Section: Discussionmentioning

confidence: 99%

“…Accompanied with chest tube obstructions, retained pleural collections could occur. Further surgical intervention(s) should be considered to prevent post-traumatic complications [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

The role of repairing lung lacerations during video-assisted thoracoscopic surgery evacuations for retained haemothorax caused by blunt chest trauma

Chou

Kuo

Soo

et al. 2013

European Journal of Cardio-Thoracic Surgery

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“…The number of anatomic structures potentially affected during TT placement includes primary and secondary injuries of the lung, intercostal/intrathoracic vasculature, esophagus, stomach, liver, spleen, diaphragm, major blood vessels, and even cardiac structures. [8910111213141516] While TT complications can be categorized as acute or chronic, procedural and non-procedural, provider- and patient-related, we have chosen to categorize them into organ-specific complications and thoracic cage complications/injuries (extrapulmonary anatomic, physiological, technical, and miscellaneous). We will briefly address procedural technical/safety considerations and follow with a review of individual complications.…”

Section: Introductionmentioning

confidence: 99%

“…Common complications include pain from nerve impingement, subcutaneous emphysema, pneumothorax, direct injuries to the lung, injury of the diaphragm and intraabdominal organs, chylothorax, and neurologic complications (Horner's syndrome, winging of the scapula, acute diaphragmatic paralysis). [13] Tube entrapment under sternal sutures is uncommon; Berkow and Salo reported 5 cases among 759 median sternotomies performed. [45]…”

Section: Introductionmentioning

confidence: 99%

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Thoracostomy tubes: A comprehensive review of complications and related topics

Stawicki¹,

Kwiatt²,

Tarbox³

et al. 2014

Int J Crit Illn Inj Sci

169

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Tube thoracostomy (TT) placement belongs among the most commonly performed procedures. Despite many benefits of TT drainage, potential for significant morbidity and mortality exists. Abdominal or thoracic injury, fistula formation and vascular trauma are among the most serious, but more common complications such as recurrent pneumothorax, insertion site infection and nonfunctioning or malpositioned TT also represent a significant source of morbidity and treatment cost. Awareness of potential complications and familiarity with associated preventive, diagnostic and treatment strategies are fundamental to satisfactory patient outcomes. This review focuses on chest tube complications and related topics, with emphasis on prevention and problem-oriented approaches to diagnosis and treatment. The authors hope that this manuscript will serve as a valuable foundation for those who wish to become adept at the management of chest tubes.

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Posttraumatic Empyema

et al. 1997

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The extent of pulmonary injury (pulmonary contusion) is an important predictor of empyema development. Previously implicated factors such as setting in which a TT was performed and mechanism of injury did not correlate with the development of posttraumatic empyema. Based on the results of our study, we recommend early drainage of the pleural space with video-assisted thoracoscopic techniques in patients at risk of empyema, which may spare them the morbidity of a thoracotomy.

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Tube Thoracostomy

Abstract: Tube thoracostomy is associated with significant morbidity. The striking difference in the complication rate between surgeons and other physicians who perform this procedure suggests that additional training may be indicated.

Cited by 192 publications

References 7 publications

The role of repairing lung lacerations during video-assisted thoracoscopic surgery evacuations for retained haemothorax caused by blunt chest trauma

The role of repairing lung lacerations during video-assisted thoracoscopic surgery evacuations for retained haemothorax caused by blunt chest trauma

Thoracostomy tubes: A comprehensive review of complications and related topics

Posttraumatic Empyema

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