[Treating iatrogenic pneumothorax with small-bore chest tube].
OBJECTIVE
To evaluate the feasibility of small-bore chest tube placement to treat pneumothorax caused by percutaneous procedures.


METHODS
Between November 2004 and July 2006 we performed 151 interventional chest procedures (127 biopsies and 24 radiofrequency ablations) in 131 patients (25 women and 106 men; mean age, 63 years, range, 36-83 years). Fine needles (21-25 G) were used in 70 procedures and large core needles (14-20 G) were used in the remaining 81. Pneumothorax occurred in 16 diagnostic procedures (13 of these were treated with small-bore catheter placement) and in two radiofrequency procedures (both cases were treated with small-bore catheter placement). Chest tubes were placed immediately after pneumothorax occurred in all cases because the pneumothorax was greater than 20% or caused symptoms or occurred in patients with emphysema.


RESULTS
Chest tubes were successfully placed without incidents in all cases and a Heimlich valve evacuated the air completely. Mean hospital stay was 43 hours (range, 24-72 hours). It was not necessary to place a larger-bore chest tube in any case.


CONCLUSIONS
Small-bore chest tube placement is the treatment of choice for iatrogenic pneumothorax greater than 20% or less than 20% when symptomatic or occurring in patients with emphysema. The procedure is easy, effective, and well tolerated; furthermore, it shortens the hospital stay. The effectiveness of the procedure makes it possible to safely perform percutaneous procedures on patients with emphysema or difficult lesions and to finish an interventional procedure when pneumothorax occurs.
Jornet
J
J
Servicio de Radiología, Hospital de la Ribera, Alzira, Valencia, Spain. jjornet@hospital-ribera.com
Pallardó
Y
Y
Revert
A J
AJ
Marcelo Galbis
J
J
Mollá
E
E
Sales
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology / Q000628:therapy*; D011677:Punctures / Q000009:adverse effects