Complications and Pitfalls of Tube Thoracostomy: A Comprehensive Analysis from a Tertiary Thoracic Surgery Centre

Abstract

Abstract:

Background and Objectives:

Catastrophic chest injuries are increasingly encountered in emergency settings, requiring prompt and effective management. Tube thoracostomy remains a vital, life-saving procedure for traumatic conditions However, despite its common use, this intervention carries significant risks and complications. This study was conducted to evaluate the frequency, nature, and causes of complications and hazards associated with tube thoracostomy.

Methods:

The (Department name) of the (hospital name) conducted this retrospective analysis from May 2024 to April 2025.  The trial involved a total of 800 patients. Common errors related to the care of the tube thoracostomy and its system, as well as complications associated with the tube insertion, were recorded and examined.

Results:

In our study of 700 patients, the majority were aged 12–50 years (68.6%), with 75.1% being male. A total of 244 (34.85%) complications were recorded, predominantly lung parenchymal placement (66.8%), followed by extra-pleural misplacements (20.08%), subcutaneous emphysema (6.96%), abdominal injuries (2.4%), and others. Additionally, 323 (46.14%) procedural hazards were noted, including ineffective placement requiring re-intervention (34.98%), post-procedural empyema or clotted hemothorax needing decortication (25.07%), inappropriate clamping (10.83%), suction mismanagement (8.6%), covered outlet vents (6.81%),  few and others.

Conclusion:

Tube thoracostomy is a vital yet potentially hazardous procedure. Our findings highlight that complications are common, particularly in emergency settings and when performed by less experienced personnel. Proper technique, anatomical awareness, and staff education are crucial to minimizing risks. This study reinforces the need for standardized training and adherence to safety protocols in chest tube management.