Transabdominal assisted ICD insertion minimise the malposition of tubes our experience compared with standard technique
Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 2
Abstract
Background: Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Normally after the closure of abdomen ICD is inserted blindly in 4th or 5th intercostal space in safe triangle. Still the risk of lung injury or malplacement is possible. In modified technique ICD is inserted into pleural cavity before abdomen closed with transabdominal manipulation Aim: To compare the between the tube thoracostomy by standard technique and our assisted technique. Materials and Methods: we have operated 50 cases of carcinoma of the postcricoid region since Jan 2012 to Dec 2016. They underwent laryngo-pharyngo-esophagectomy with gastric pullup. Random cases were selected for intercostals drain insertion either trans-abdominal assisted technique or by standard technique. Results: Total 50 cases of gastric pull-up were operated. In that 50% had ICD insertion by standard technique and other 50% by trans-abdominal assisted technique. Three patients (12%) had malposition of drains in standard technique which required reposition. None of the patients had malposition of ICD in modified technique. Conclusion: Tube thoracostomy, though commonly performed is not without risk. Assisted tube insertion technique has lower risk of complications and it can be recommended.
Authors and Affiliations
Siddappa K Thammaiah, Krishnappa Ramachandrappa
Keywords
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