Raheel Hussain.
Is chest tube necessary in every thoracotomy.
Pak J Chest Med Jan ;11(4):26-8.

A retrospective review of case files was done. Over a period of 2 years from May 1998 till April 2000, 17 thoracotomies were performed by a single surgeon for Hydatid disease of lung. Patients were admitted a day or two in advance of surgery. Surgery was carried out under general anaesthesia, in lateral thoracotomy position. After completion of procedure haemostasis was ensured. Air was evacuated through a temporary under water seal tube introduced in chest cavity through the wound. Evacuation of air was ensured by manual hyper inflation of lung by the anaesthetist while the wound was being closed. This tube was then withdrawn while lung remained hyperinflated. After recovery from anesthesia, respiratory rate and Oxygen saturation were monitored aiming a saturation of above 96% on room air. Post operative Chest x-ray was routinely performed, to ensure satisfactory pulmonary expansion and complete evacuation of air. Results: All the patients recovered fully from anesthesia within 2 hour of completion of surgery. With this protocol, patients remained stable and comfortable. Oxygen saturation always remained above the desired level. Four patients developed surgical emphysema over the wound site. Conclusion: It is felt that surgery for removal of Hydatid disease from thorax can be carried out without retaining a chest tube at the end. This expedites recovery, shortens hospital stay, saves patient from discomfort and any possible complication of it.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com