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Pulmonary Medicine
Volume 2012, Article ID 256878, 10 pages
http://dx.doi.org/10.1155/2012/256878
Review Article

Tube Thoracostomy: Complications and Its Management

1Department of Surgery, Irrua Specialist Teaching Hospital, PMB 8, Irrua, Edo State, Nigeria
2National Cardiothoracic Center, University of Nigeria Teaching Hospital, Enugu, Nigeria
3Department of Surgery, University of Port-Harcourt Teaching Hospital, PMB 6173, Port-Harcourt, Nigeria
4Paediatric Intensive Care Unit, Irrua Specialist Teaching Hospital, PMB 8, Irrua, Edo State, Nigeria

Received 22 April 2011; Accepted 9 August 2011

Academic Editor: Joseph S. Friedberg

Copyright © 2012 Emeka B. Kesieme et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended.