Management of Pleural Fluid Collection with Tube Thoracostomy in a Tertiary Health Facility in Abakaliki, Nigeria.

Abstract

Context: Fluid collection in the pleural space following pleural and pulmonary disease and trauma remain a major problem in developing countries. The judicious use of antibiotics and tube thoracostomy remains a management modality. Objective: To determine the pattern, indications and complications associated with tube thoracostomy in a tertiary health centre. Methods: Descriptive analysis of retrospective data on all patients who underwent tube thoracostomy at the Ebonyi State University Teaching Hospital, Abakaliki betweem 2000 and 2005. Results: There was a total of eigty five cases during the study period with a male to female ratio of 2:1. Twenty patients (23.5%) were below 10 years of age. Infective cases accounted for 52 (61.2%) of the cases that had thoracostomy. Fifty-two patients had tube drainage for twelve days or less. Complications were recorded in 22 (25.9%) patients, and dislodgement of the tube accounted for about half of the cases. There were eight failures (9.4%) and four deaths (4.7%). However, no death was related to the procedure. Conclusion: Closed tube thoracostomy is a simple and efficacious procedure for the treatment of pleural space collections such as empyema. The safety of the procedure can be improved upon by adequate training of residents in the insertion procedure, while proper selection of cases will reduce failure rate and unnecessary morbidity. Early resort to thoracoscopic op open surgery when closed tube thoracostomy has failed will improve the success rate in the overall management of pleural fluid collections.

Key words: Tube thoracostomy, indications, outcome and complications.