Chest Tube Placement (Thoracostomy) and Pleurodesis

Thoracostomy inserts a thin plastic tube into the space between the lungs and the chest wall. The doctor may attach the tube to a suction device to remove excess fluid or air. Or, the doctor may use it to deliver medication into the space to decrease the likelihood that fluid will accumulate. This is called pleurodesis. Your doctor may use thoracostomy to treat pneumothorax, also known as collapsed lung.

Your doctor will tell you how to prepare, including any changes to your medication schedule. Tell them if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, allergies, and medications you're taking, including herbal supplements and aspirin. They may tell you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners several days prior to your procedure. Leave jewelry at home and wear loose, comfortable clothing. You may need to change into a gown for the procedure.

What is chest tube placement (thoracostomy) and pleurodesis?

Thoracostomy is a minimally invasive procedure in which a doctor inserts a thin plastic tube into the thoracentesis, pleurodesis is generally a long-term, even permanent solution to prevent the accumulation of pleural fluid.

What are some common uses of the procedure?

Physicians perform a thoracostomy to treat conditions including:

Pleurodesis is performed to prevent the recurrent collection of pleural fluid following thoracentesis.

How should I prepare?

The preparation for placement of a chest tube and tunneled pleural drainage catheter is similar.

Tell your doctor about all the medications you take, including herbal supplements. List any allergies, especially to Radiation Safety page for more information about pregnancy and x-rays.

What does the equipment look like?

Your doctor may use computed tomography (CT) , ultrasound or

The CT scanner is typically a large, donut-shaped machine with a short tunnel in the center. You will lie on a narrow table that slides in and out of this short tunnel. Rotating around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a ring, called a gantry. The computer workstation that processes the imaging information is in a separate control room. This is where the technologist operates the scanner and monitors your exam in direct visual contact. The technologist will be able to hear and talk to you using a speaker and microphone.

Ultrasound machines consist of a computer console, video monitor and an attached top of page

How does the procedure work?

Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of the radiation while soft tissue (muscle, fat, and organs) allow more of the x-rays to pass through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray, and air appears black.

Ultrasound imaging uses the same principles as the sonar that bats, ships, and fishermen use. When a sound wave strikes an object, it bounces back or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as its size, shape, and consistency. This includes whether the object is solid or filled with fluid.

Doctors use ultrasound to detect changes in the appearance of organs, tissues, and vessels and to detect abnormal masses, such as tumors.

In an ultrasound exam, a

Modern CT scanners can image large sections of the body in just a few seconds, and even faster in small children. Such speed is beneficial for all patients. Speed is especially beneficial for children, the elderly, and critically ill – anyone who finds it difficult to stay still, even for the brief time necessary to obtain images.

X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. The technologist carefully aims the x-ray beam at the area of interest. The machine produces a small burst of radiation that passes through your body. The radiation records an image on photographic film or a special detector.

How is the procedure performed?

Your doctor may provide medications to help prevent nausea and pain and antibiotics to help prevent infection.

You will lie on the procedure table.

The doctor or nurse may connect you to monitors that track your heart rate, blood pressure, oxygen level, and pulse.

What will I experience during and after the procedure?

You will feel a slight pinch when the nurse inserts the needle into your vein for the IV line and when they inject the local anesthetic. Most of the sensation is at the skin incision site. The doctor will numb this area using local anesthetic. You may feel pressure when the doctor inserts the catheter into the vein or artery. However, you will not feel serious discomfort.

If the procedure uses sedation, you will feel relaxed, sleepy, and comfortable. You may or may not remain awake, depending on how deeply you are sedated.

You may feel slight pressure when the doctor inserts the top of page

Who interprets the results and how do I get them?

What are the benefits vs. risks?

Benefits

Risks