COMPLICATIONS AND PITFALLS OF TUBE THORACOSTOMY AT A TERTIARY CARE HOSPITAL
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Keywords
Complications, pitfalls, Tube Thoracostomy
Abstract
Background: A tube thoracostomy is an essential life-saving technique for the treatment of pneumonia, hemotopneumothorax, and hemopneumothorax arising from trauma to the chest
Objective; the aim of the study was to determine the Complications and pitfalls of Tube Thoracostomy at a Tertiary Care Hospital
Method and materials; this cross-sectional study was carried out at the department of Pulmonology, GMMMC hospital Sukkur. The study duration was six months From January 2023 to June 2023 after taking approval from the ethical committee of the institute. A total of 304 individuals were enrolled in this study who experienced a drainage technique of the pleural cavity by a thoracostomy chest tube. Chest tubes that were implanted at the cardiac center were excluded from the study. A chest X-ray was done after the tube was inserted, daily thereafter, and after it was removed. Done a CT scan of the chest if necessary. The thoracic surgical team monitored the chest tubes and their drainage system every day until the day of their removal. Any issues pertaining to the chest tube's insertion as well as any inaccuracies made in the maintenance and handling of the tube and its system were noted. The statistical analysis was carried out with SPSS 27.0 and the variable were expressed in the form of mean ± SD and percentages.
Results: A total of 304 individuals whose age was from 20-60 years were included in this study. Out of which 187 were male and 117 were females. 174 (57.2%) thoracostomy tubes were inserted in the operating room following thoracoscopic or open surgery; 92 (30.2%) went into the surgical and critical care units; 42 (13.8%) went into the emergency room. The most prevalent indication of thoracostomy tube insertion was post thoracotomy (52.9%).Tube insertion complications were 8.5%. The most common complication was iatrogenic lung injuries 4.6% followed by diaphragmatic injury 1.6% and injury of intercostal vessel 1.3% correspondingly. A total 126 (41.4%) pitfalls were detected, amongst which the most prevalent was clamping the chest tube 30 (9.8%), tailed by intrathoracic malposition 23 (7.5%), loose fixation 19 (6.2%), inappropriate handling of suction system 16 (5.2%), vent covering 13 (4.2%), inappropriate filling of the bottle 10 (3.2%), subcutaneous position 7( 2. 6%) ,inappropriate insertion site 8 ( 2.6%) correspondingly.
Conclusion: The majority of the complications were brought on by the trocar-inserted chest tube. Therefore, inexperienced consultants ought to avoid from employing chest tubes with trocars.
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Shafi Muhammad khuhawar
Associate Professor, Head of the department of pulmonology, GMMMC Sukkur
Jagdesh Kumar
Assistant Professor Department of Pulmonology GMMMC Sukkur
Khalil Ahmed Sanghro
Senior Registrar Department of Medicine GMMMC Sukkur
Bashir Ahmed Chandio
Assistant Professor of Medicine, Ghulam Muhammad Mahar Medical College Sukkur
Murk kukreja
Medical officer in NIBD karachi