title: A novel and safe technique in closed tube thoracostomy.
abstract: BACKGROUND
  Tube thoracostomy (TT) is the most commonly performed surgical procedure in thoracic surgery clinics. The procedure might have to be repeated due to ineffective drainage in patients with tube malposition (TM), in whom the drain is not directed to the apex or located in the fissure. Trocar technique, which is used to prevent TM, is not recommended because of its potential for severe complications.
  
  
  METHODS
  The study involved 180 patients who required TT application for any etiology within one year. The patients were divided into two groups as Group A, who had undergone classical surgical technique (n = 90) and Group B, who had undergone a combination of surgery and trocar techniques (n = 90). The groups were compared for TM, the effect of TM on the drain removal, and other insertion related complications.
  
  
  RESULTS
  In Group A, 23 patients had TM, 4 of whom developed associated ineffective drainage, while the patients in Group B had no insertion related complications (p = 0.001). The mean drain removal time of the patients with TM was 5 +/- 2.25 days. In the patients who did not develop TM, it was 3.39 +/- 1.18 days (p = 0.001).
  
  
  CONCLUSIONS
  The modified combination technique is a reliable method in preventing TM and its potential complications.
authors.affiliation: Numune Teaching and Research Hospital, Division of Thoracic Surgery, Ankara, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Dural
authors.forename: Gultekin
authors.initials: G
authors.lastname: Gulbahar
authors.forename: Bulent
authors.initials: B
authors.lastname: Kocer
authors.forename: Unal
authors.initials: U
authors.lastname: Sakinci
mesh_terms: D000328:Adult; D015505:Chest Tubes / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D013898:Thoracic Injuries / Q000601:surgery; D013907:Thoracostomy / Q000379:methods*; D014951:Wounds, Stab / Q000601:surgery