Type of Surgery
Information
Last updated: 02/17/2009
The diagnosis for chest tube insertion depends on the primary cause of fluid or air in the pleural cavity. For malignancy (cancer)-causing pleural effusion (fluid in the pleural space filled with malignant cells), the diagnosis can be established with...
positive cytopathology (cancer cell visualization and analysis) and a chest x ray that shows fluid accumulation.
The typical diagnostic signs and symptoms of empyema (lung infection) include fever, cough, and sputum discharge as well as the development of pleural effusion (causing chest pain and shortness of breath). This type of lung infection can progress to systemic disease with such signs as weakness, and loss of appetite (anorexia). Chest x rays can readily allow the clinician to view the pleural effusion and can also help to detect pneumothorax, since there is visual proof in the displacement of the tissues covering the lungs as a result of air in the pleural cavity. Additionally, during physical examinations, people with pnemothorax have diminished breath sounds, hyperesonance on percussion (a highly resonating sound when the physician taps gently on a patient's back), and diminished ability to expand the chest. Computed axial tomography (CAT) scans can be used to visualize and analyze complicated cases that may require chest tube insertion.
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Other Information
Definition:
Surgical insertion of a hollow, flexible drainage tube into the chest.
Alternative Names:
Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy
Description:
Chest tubes are inserted to drain blood, fluid, or air and allow full expansion of the lungs. The tube is placed between the ribs and into the space between the inner lining and the outer lining of the lung (pleural space).
The area where the tube will be inserted is numbed (local anesthesia). The patient may also be sedated. The chest tube is inserted through an incision between the ribs into the chest and is connected to a bottle or canister that contains sterile water. Suction is attached to the system to encourage drainage. A stitch (suture) and adhesive tape is used to keep the tube in place.
The chest tube usually remains in place until the X-rays show that all the blood, fluid, or air has drained from the chest and the lung has fully re-expanded. When the chest tube is no longer needed, it can be easily removed, usually without the need for medications to sedate or numb the patient. Medications may be used to prevent or treat infection (antibiotics).
In certain patients, the chest tube may be inserted using a minimally invasive technique under radiographic guidance.
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