Experience of First 250 Cases of Tube Thoracostomy Under Thoracic Surgery Unit of BSMMU, Dhaka, Bangladesh

Background: The most commonly performed surgical procedure in thoracic surgery is Tube thoracostomy. General surgeons, intensivists, emergency physicians, and respiratory physicians may at one time or the other be required to perform tube thoracostomy as a lifesaving procedure. Objective: To observe experience of tube thoracostomy under thoracic surgery unit of BSMMU, Dhaka, Bangladesh. Methodology: This was a prospective, descriptive study conducted at thoracic surgery unit of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Study duration was from 02.12.2018 to 01.10.2021, total 2 years and 10 months. All patients of all age group such as from 2 years of age to 93 years of age those who underwent Tube thoracostomy under thoracic surgery unit were included in the study. All the data were collected for age, sex, occupation, indications of tube thoracostomy, post procedural complications & hospital stay. Results: 250 patients of different pathologies related to chest underwent tube thoracostomy during this period. Mean age was 47.53 years SD± 2.15; minimum age was 2 years and maximum age was 93 years. Among them 173 (69.2%) were male and 77 (30.8%) were female. Male to female ratio was 2.24: 1. Pleural effusion was the most common indication of tube thoracostomy which was in 141 (56.4%) patients followed by pneumothorax 21 (11.6%) patients. Regarding the etiology for tube thoracostomy, it was found that Shows in (Figure 2) Routine 219 cases 87.6% and Emergency 31 cases 12.4% (Due to chest trauma following road traffic accident, during CV catheterization, during lung biopsy), which includes 141 (56.4%) patients of pleural effusion, 29 (11.6%) patients of hydro pneumothorax, and 27 (10.8%) patients of empyema thoracic. Postoperative complications were recognized in 8 patients in shows (Figure 6). It includes Surgical site infection in 5 (2.0%) patients and accidental withdrawal of chest tube by patient himself 3 (1.2%) had dislodged. In 56.0% cases chest drain tube was removed within 7 days (Table 3). Chest drain tube was always given in “Safety triangle”. All cases were done by local anesthesia (2% lignocaine injection). Mean hospital stay was 15.5 days with the range of 2 to 45 days. Conclusion: Chest tube insertion is the first line treatment for variety of life-threatening chest diseases. This is a safe & effective procedure with 3.2% post procedural complications which is comparable to international literature.