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Position and size of tube chest drainage, what impact in pneumothorax outcome?


Lamia Missaoui1, Haifa Zaibi1, Aymen Ayari1, Jihen Ben Amar1, M. Ali Baccar1, Salwa Azzebi1, Besma Dhahri1 and Hichem Aouina1
1Service de Pneumologie, Hopital Charles Nicolle, Tunis, Tunisia

Chest tube drainage (CTD) is the most common choice for treatment of pneumothorax. The optimal position and chest tube size for the drainage is unknown. This study proposed to evaluate the short term effect of pneumothorax treatment according to size and position of chest tube.

METHODS: Patients with an episode of pneumothorax who required pleural intervention were enrolled in the study.Clinical demographic data and outcomes, including success rate, complications, drainage duration, residual pneumothoraces and the need for surgical intervention were collected and analyzed.

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RESULTS: The study group included 69 patients (mean age 39.75±17.3 years); with 25 and 38 allocated to small and large chest tube drainage groups, respectively. The approach of CTD was performed with the apical approach on 45 (70.3%) and axillary on 19 patients (29.7%). There were no statistically significant differences in terms of sex, of demographic data, complaint duration, first line treatment success, number of an unresolved pneumothorax and size of pneumothorax in either group. Compared with patients treated with smaller chest tubes, patients with large-bore tubes had more complications (13.15% versus 4%), a longer duration of chest tube (10.71 versus 8.64 days; p = 0.033) and of hospitalization (12.13 versus 9.12 days; p = 0.031).Regarding their placement, no significant difference was observed in outcomes between apical and axillary approaches.

CONCLUSIONS: We found small chest tubes to be superior to large-bore chest tubes with regard to short-term outcomes in the treatment of pneumothorax. Location of CTD does not influence their outcomes.

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PDPI Jatim. 15/01/18.

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