Background: Tube thoracostomy is a surgical method frequently used by thoracic surgeons and emergency physicians to drain air, fluid, pus, blood and bile from the pleural cavity. In our study, we aimed to evaluate the demographic and clinical characteristics, complications, morbidity/mortality of patients who underwent tube thoracostomy in the emergency department of our hospital.
Methods: We retrospectively analysed 111 patients who presented to the emergency department and underwent tube thoracostomy. Pearson chi-square test, Fisher's Exact test and Mann Whitney U test were used to analyse the data in our study.
Results: In our study, 22.5% (25) of the patients died and 54.1% (60) were discharged. The mean duration of hospitalisation was 8.9±6.3 days. Among the patients who underwent tube thoracostomy, 79.3% (88) had traumatic and 20.7% (23) had spontaneous pneumothorax. The incidence of pneumothorax was significantly higher in patients under 40 years of age than in patients over 40 years of age (p=0.003). Complications developed in 17.1% (19) of the patients. The most common complication was malposition.
Conclusion: Tube thoracostomy is frequently performed in our emergency department. Although it is a life-saving procedure, complications are common and may result in death. Morbidity and mortality can be reduced with experience and compliance with surgical sterility.
tube thoracostomy, complication, pneumothorax, emergency department
Afacan, M. A. (2012). Acil Servise Başvuran Künt Toraks Travma Vakalarının İncelenmesi. J Emerg Med, 3(6), 135.
Afshar, M., Aghaei, M., Mangelı, F., & Nakhaeı, A. (2015). Evaluation of injuries caused by penetrating chest traumas in patients referred to the emergency room. Indian Journal of Surgery, 77(3), 191–194.
Ak, G. (2001). Parapnömonik efüzyon ve ampiyemli hastaların özellikleri. Toraks Derneği, 1(1), 23–27.
Ball, C. G. (2007). Chest tube complications: How well are we training our residents? Canadian Journal of Surgery, 50(6), 450.
Çakan, A. (2001). Göğüs Travmaları: 987 Olgunun Analizi. Ulus Travma Acil Cerrahi Derg, 7(4), 236–241.
Chan, L., Reilly, K. M., Henderson, C., Kahn, F., & Salluzzo, R. F. (1997). Complication rates of tube thoracostomy. American Journal of Emergency Medicine, 15(3), 68–70.
Çorbacioğlu, S. K. (2015). The significance of routine thoracic computed tomography in patients with blunt chest trauma. Injury, 46(5), 849–853.
Değirmenci, M. (2006). Spontan Pnömotoraks Olgularının Retrospektif olarak Değerlendirilmesi [Unpublished master's thesis]. Trakya Üniversitesi.
Deneuville, M. (2002). Morbidity of percutaneous tube thoracostomy in trauma patients. European Journal of Cardio-Thoracic Surgery, 22(5), 673–678.
Durai, R., Hoque, H., & Davies, T. W. (2010). Managing a chest tube and drainage system. AORN Journal, 91(2), 275–283.
Edaigbini, S. A. (2014). Indications and complications of tube thoracostomy with improvised underwater seal bottles. Nigerian Journal of Surgery, 20(2), 79–82.
Ergenç, H. (2017). Acil Tıp Kliniğinde Uygulanan Tüp Torakostomi Girişimlerinin Retrospektif Olarak İncelenmesi [Unpublished master's thesis]. İstanbul.
Iberti, T. J., & Stern, P. M. (1992). Chest tube thoracostomy. Crit Care Clin, 8(1), 879–895.
Ince, A. (2013). Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial. Iranian Red Crescent Medical Journal, 15(1), 2.
John, S. J., & Piskorowski, T. (2005). Bronchocutaneous fistula after chest-tube placement: A rare complication of tube thoracostomy. Heart and Lung, 34(4), 279–281.
Kantar, Y. (2016). Acil Serviste Tüp Torakostomi Uygulanan Hastaların Değerlendirilmesi [Unpublished master's thesis]. Kayseri.
Kesieme, E. B. (2011). Tube thoracostomy: Complications and its management. Pulmonary Medicine, 20(12), 23.
Kesim, A. (2013). Tüp torakostomi uygulanan toraks travmalı 85 hastanın analizi. Medical Journal of Suleyman Demirel University, 20(2), 6–7.
Kong, V. Y., Oosthuızen, G. V., & Clarke, D. L. (2015). What is the yield of routine chest radiography following tube thoracostomy for trauma? Injury, 46(1), 45–48.
Kuhajda, I. (2014). Tube thoracostomy ve chest tube implantation and follow up. Journal of Thoracic Disease, 6(Suppl 4), 470.
Kwiatt, M. (2014). Thoracostomy tubes: A comprehensive review of complications and related topics. International Journal of Critical Illness and Injury Science, 4(2), 143.
Martin, M. (2013). Results of a clinical practice algorithm for the management of thoracostomy tubes placed for traumatic mechanism. SpringerPlus, 2(1), 642.
Sethuraman, K. N., Duong, D., Mehta, S., Director, T., Crawford, D., St George, J., et al. (2011). Complications of tube thoracostomy placement in the emergency department. J Emerg Med, 40(1), 14–20.
Shapira, O. M., Aldea, G. S., Kupferschmid, J., & Shemin, R. I. (1993). Delayed perforation of the esophagus by a closed thoracostomy tube. Chest, 104(6), 1897–1898.
Şentürk, E. (2011). [Article title not provided]. Turkiye Klinikleri ArchLung, 12(1), 1–8.
Yucel, O. (2009). Hastaneye yatırılmayı gerektiren toraks travmalı 748 olgunun analizi. Gulhane Med J, 51(2), 86–90.
