Drainage pleural après thoracoscopie médicale diagnostique(TM)
Y. Khelouia (Prof), S. Alihalassa*a (Prof)
a Public hospital establishment of Blida/faculty of medicine/university of Blida 1, Blida, ALGERIA
1-Introduction: Unexplained pleurisy requires TM for diagnostic purposes, which ends with the placement of a chest drain, the question of the removal of the drain is not yet decided, this is the reason why we will contribute by our experience in this field to enrich the literature.
2-Material and Methods: Retrospective study on files of patients admitted for TM diagnosis between 01-01-2006 and 31-12-2010, TM for pleurodesis and pneumothorax (PNO) excluded, i.e. 191 patients included in the study.
TM is performed under local anesthesia with a single entry point, pleural exploration and biopsies performed on the parietal pleura. A chest drain 24 F is inserted and connected to a suction system at the end of the examination. Lung re-expansion is evidenced by the absence of bubbling, clinical, ultrasound and radiological examination which determine the decision to withdraw the drain.
3-Results: free pleural cavity in 132 cases (73%) and reduced in 59. Out of 191,179 pleural biopsies performed, 85 (47.5%) malignant, 45 (25%) infectious, 41 (22%) non-specific inflammatory, 8 ( 4.5%) normal. Less than 4 hours of drainage in 121 cases (63%), 24 to 48 hours 52 cases (27%) more than 48 hours 18 cases (9%). Hospitalization was on average 14 days with 50% between 0 and 7 days, 30 % between 7 and 10 days, 18% more than 10 days. Complications were rare 08 cases in total (4%): 2 subcutaneous emphysemas, 03 sepsis, 3 persistent PNO.
4-Comments and conclusion: rapid removal (in less than 4 hours or even immediately) is possible, in our study it appears that: 63% removal before 4 hours, 90% removal within 48 hours following TM, which allowed us considerably shorten the duration of hospitalization and reduce morbidity and health costs.
Disclosure of funding source(s): none