CHEST TUBEDEFINITION--Insertion of a tube into the pleural space (space between the two thin coverings of the lung).BODY PARTS INVOLVED -Skin; muscles of the chest wall; pleural space.

REASONS FOR SURGERY

Treatment for pneumothorax (air in the pleural space that causes lung to collapse); hemothorax (blood in the chest); empyema (pus in the chest).The procedure allows removal of air, blood, pus or fluid from the pleural space.

SURGICAL RISK INCREASES WITHSURGICAL RISK INCREASES WITHObesity; smoking.Excess alcohol consumption.Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.

DIAGNOSTIC TESTS

Before surgery: Blood and urine studies; X-rays of chest.During surgery: Chest X-rays.After surgery: Chest X-rays.

ANESTHESIA

Local (usually).

DESCRIPTION OF OPERATION

Patient sits up or lies on the unaffected side.Local anesthesia is injected.A small incision is made in 1 or 2 places on the skin overlying the chest.The surgeon tunnels the tube through the tissue into the pleural space. The tubes may be placed in front, back or side of the chest, usually in the 2nd, 3rd or 8th rib space.The external end of the tube is immediately connected to an underwater-seal drainage system. Tubes are taped into place.

POSSIBLE COMPLICATIONSExcessive bleeding; surgical-wound infection; pneumonia.AVERAGE HOSPITAL STAY--1 to 14 days.

PROBABLE OUTCOME

Underlying disease usually curable.Allow about 2 to 4 weeks for recovery from surgery.