Background and Objective: Closed tube thoracostomy is one of the most common hospital procedures known for its effectivity and safety; however, complications may occur, leading to poor patient outcomes. To date, the burden of morbidity among patients who underwent closed tube thoracostomy in the Philippines remains unknown. Therefore, this study aims to determine the in-hospital morbidity rate among patients who underwent closed tube thoracostomy in a tertiary government hospital. Methods: This is a descriptive cross-sectional study of admitted patients who underwent closed tube thoracostomy at Bicol Medical Center from 2015 to 2020. Data were collected by reviewing medical charts. Results: A total of 376 patients were included in the study. Morbidity rate was 15.16% (95% CI: 11.69-19.19%), and majority were due to improper chest tube placement. Compared to those without complications, a higher proportion of patients with complications had pleural effusion and had chest tube failure (both p≤0.05). The median operative time was also significantly longer in patients with complications compared to those without complications (p=0.0012). Mortality was significantly lower in patients with complications than those without complications. Total and postoperative length of stay were significantly longer in patients with complications than those without complications (p<0.00001). Conclusion Complications after closed tube thoracostomy are common. Across all variables analyzed, only indication of chest tube insertion, operative time, and occurrence of chest tube failure were found to differ between patients with and without complications. Moreover, patients with complications had longer length of stay than those without. Reducing positional tube complications may help decrease in-hospital morbidity.
chest tube ; morbidity

Mediastinitis is a life-threatening disease, and effective drainage is needed to treat mediastinitis with abscess formation. We recommend an alternative drainage method using chest tube binding with a Silastic Penrose drainage tube. The use of a Silastic Penrose drainage tube may help to manage mediastinitis with abscess formation. This method facilitates effective draining and prevents tissue adhesion.
Abscess ; Chest Tubes ; Drainage* ; Mediastinitis* ; Tissue Adhesions

Primary fetal hydrothorax presents a wide spectrum of severity ranging from small harmless effusions to life-threatening thoracic compression. Management of this condition is controversial. We experienced a case of non-chylous primary fetal hydrothorax not associated with hydrops or other malformations. A predominantly unilateral hydrothorax in a fetus was diagnosed by sonography at 31 weeks gestation. Repeated ultrasonographic examinations to detect development of hydrops or progression of intrapleural effusion were used to evaluate the need for intrauterine thoracentesis and to decide the optimal time for delivery. Two thoracenteses were performed. The baby was delivered at 34 weeks. Postnatal intubation was carried out in the baby, and then chest tube placement was performed and resulted in the collection of 805ml of serous fluid. Sustained intubation was necessary for 16 days because of developing respiratory distress as a result of prematurity and recurrent pleural fluid accumulation. The baby did well after postnatal evacuation of the intrapleural fluid. Pre and postnatal investigation to find the pathophysiological mechanism leading to hydrothorax were negative. We conclude that non-chylous primary fetal hydrothorax is generally associated with a favorable outcome.
Chest Tubes ; Edema ; Fetus ; Hydrothorax ; Intubation ; Pregnancy

Spontaneous hemo-pneumothorax, a hemothorax that occurs without trauma, is a very rare condition; however, as a result of excessive bleeding, it can be lethal. Also, if the bleeding is scanty, the physician might recognize hemothorax in case of performing invasive procedures, such as chest tube insertion, and may misunder stand as a complication of the procedure. For this reason, acknowledgement of the spontaneous hemo-pneumothorax in the emergency department is very important. We report on a case of a spontaneous hemo-pneumothorax in a healthy 18-year-old male presenting with chest pain who developed a spontaneous pneumothorax with a profuse amount of hemothorax.
Chest Pain ; Chest Tubes ; Emergencies ; Hemorrhage ; Hemothorax ; Humans ; Male ; Pneumothorax

Endoscopic submucosal dissection (ESD) is widely accepted as an alternative treatment to surgical resection for gastric neoplastic lesions. Among the complications of gastric ESD, perforation is usually manifested as a pneumoperitoneum. Here, we report a patient with a right-sided pneumothorax, pneumoperitoneum, and pneumoretroperitoneum as complications of gastric ESD. The patient recovered without further complications using conservative treatment, including endoscopic clipping, nasogastric drainage, and insertion of a chest tube.
Chest Tubes ; Drainage ; Endoscopy ; Humans ; Pneumoperitoneum ; Pneumothorax* ; Retropneumoperitoneum

Vacuum-assisted closure therapy is an alternative method for a massive subcutaneous emphysema treatment. It is easily applicable and shows rapid effectiveness in massive subcutaneous emphysema, intractable with chest tube drainage.
Chest Tubes ; Drainage ; Negative-Pressure Wound Therapy ; Subcutaneous Emphysema

PURPOSE: Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy(AGB) is believed to be more diagnostic than materials from fine needle aspiration(FNA) by many cytopathologists. The authors evauated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complications. MATERIALS AND METHODS: We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients:AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. RESULTS: Biopsy samples sufficient for histologic diagnosis were obtained in 94(87.9%) of 107 patients, AG8 in 73(90.1%) of 81 patients and AGB and FNA in 21(80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. CONCLUSION: Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions.
Biopsy* ; Biopsy, Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax

PURPOSE: Percutaneous needle aspiration biopsy under the imaging guidance in the diagnosis of intrathoracic diseases has become a standard practice. Core tissue obtained by automated gun biopsy(AGB) is believed to be more diagnostic than materials from fine needle aspiration(FNA) by many cytopathologists. The authors evauated the role of automated gun biopsy in localized pulmonary lesions with respect to the its accuracy and complications. MATERIALS AND METHODS: We performed 107 percutaneous biopsies in localized pulmonary lesions under fluoroscopic guidance among 107 patients:AGB using 18G or 20G was done in 81 patients, and both AGB and FNA was done in 26 patients. RESULTS: Biopsy samples sufficient for histologic diagnosis were obtained in 94(87.9%) of 107 patients, AG8 in 73(90.1%) of 81 patients and AGB and FNA in 21(80.8%) of 26 patients. 11 of 13 negative results were due to inadeguate specimen size for the histologic diagnosis or were composed of necrotic areas, and 2 of 13 negative results were obtained through nontarget tissue. 10 patients developed pneumothorax and 4 of them required chest tube insertion. Minimal hemoptysis was found in 3 patients. CONCLUSION: Percutaneous automated gun biopsy under fluoroscopic guidance was easy and simple method of obtaining specimens of good quality and quantity. It may be an useful procedure in the diagnosis of localized pulmonary lesions.
Biopsy* ; Biopsy, Needle ; Chest Tubes ; Diagnosis ; Hemoptysis ; Humans ; Needles ; Pneumothorax

We report two patients, who have used Pneumostat to replace the conventional underwater seal drainage system for recurrent pneumothorax. Both patients had required repeated chest tube insertion for recurrent pneumothorax and needed a longer hospital stay. Both patients were able to be discharged with the Pneumostat device and were reviewed in outpatient clinic. Both patients had optimal clinical improvement and chest X-ray showed no residual pneumothorax.
*Ambulatory Care ; *Chest Tubes ; Drainage/*instrumentation ; Pneumothorax/*therapy

BACKGROUND: In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a Viscum album extract was used in chemical pleurodesis. We compared the effects of V. album with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the V. album extract in chemical pleurodesis for managing pulmonary air leak. METHODS: Between October 2010 and October 2016, chemical pleurodesis was performed using doxycycline in 40 patients and the V. album extract in 37 patients. Thirty-three patients were in the postoperative state after pulmonary resection, and 44 patients suffered from spontaneous pneumothorax. RESULTS: No statistically significant difference in the success rate was observed between the 2 groups (V. album extract and doxycycline). In both groups, chest pain was the most common complication. More patients in the doxycycline group complained of severe chest pain (42.1% vs. 13.5%, p=0.006). In the V. album extract group, 24.3% of the patients required a chest tube to drain the pleural effusion after cessation of the air leak (doxycycline group: 5%, p=0.022). Further, the amount of pleural effusion drained on the day after the last chemical pleurodesis in the V. album extract group was greater than that in the doxycycline group (162.2±170.2 mL vs. 97.0±77.2 mL, p=0.032). All patients were discharged from the hospital without complications after pleural effusion drainage. CONCLUSION: Considering that treatment using the V. album extract was less painful, V. album might be a feasible option for chemical pleurodesis. However, pleural effusion should be monitored carefully when using V. album extract for treating patients suffering from air leak.
Chest Pain ; Chest Tubes ; Doxycycline* ; Drainage ; Humans ; Pleural Effusion ; Pleurodesis* ; Pneumothorax ; Tetracycline ; Viscum album* ; Viscum*