Niaz Hussain, Anum Javed, Javeria Kamran, Sana Wahab.
Complications and Technical Errors of Tube Thoracostomy and its Underwater Seal System.
J Surg Pak Jan ;19(2):75-8.

Objective: To find out the complications and technical errors of tube thoracostomy and its underwater seal system in a tertiary care hospital. Study design: Descriptive case series. Place & Duration of study: Department of Thoracic Surgery Jinnah Postgraduate Medical Centre Karachi, from March 2010 to January 2012. Methodology: All patients above the age of 12 year who were admitted directly or those referred from other centres were included in this study. Indications of chest tube insertion included both traumatic and non traumatic conditions. Data collection included both technical errors as well as complications related to the procedure. Results: There were total of 144 patients managed during study period. This include 102 (70.8%) males and 42 (29.9%) females. The mean age of the patients was 32.2 year. Of total patients, 123 (85.45%) were referred from other hospitals while 21 (14.5%) were admitted directly in the ward. The most common complication related to insertion of chest tube was lung injury, (n=19, 13.19%) which resulted from the use of trocar or due to inadequate separation of the lung from the chest wall. Diaphragm injury occurred in 4 (2.78%) patients. The technical error frequently encountered was kinking of chest tube (n=25, 17.36%), followed by use of small chest tube (n=15, 10.41%). Conclusions: Tube thoracostomy resulted in number of complications of which lung injury was most common. This occurred mainly due to trocar used for insertion. Kinking of tube was the most common technical error in the series.

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