title: Computed tomography evaluation of different chest tube sites for residual pleural volumes after coronary artery bypass surgery.
abstract: OBJECTIVE
  We investigated the efficacy of pleural drainage with the use of different chest tube methods in patients after coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  Prospective randomized study of 60 patients undergoing elective on-pump single CABG surgery.
  
  
  METHODS
  The left internal mammary arterial grafts were harvested from all patients. The patients were separated into three groups: In one group (IC6, n=20), pleural tubes were inserted through the sixth intercostal space at the midaxillary line; in the second group (SX-r, n=20), rigid straight pleural tubes were inserted from the mediastinum through the subxiphoid area; and in the third group (SX-s, n=20), soft curved drainage tubes were inserted from the mediastinum through the subxiphoid area. The residual pleural effusion was examined by multislice CT scans within 8 hours of removal of the drainage tubes. Pain was evaluated according to standard methods.
  
  
  RESULTS
  The groups did not differ with respect to volume of residual pleural effusion (P >.05). The IC6 group had a higher mean pain score than the other two groups (P <.05), whose mean pain scores did not differ significantly from each other (P >.05). IC6 group patients had a higher requirement for analgesics. The rate of atelectasis was higher in group IC6 (P <.05).
  
  
  CONCLUSIONS
  CT scans revealed that different chest tube insertion sites have the same efficiency for draining of pleural effusion, although drainage tubes inserted through the thoracic cage may result in more severe pain.
authors.affiliation: Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. ysensoz@yahoo.com
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Sensoz
authors.forename: Rafet
authors.initials: R
authors.lastname: Gunay
authors.forename: Abdullah Kemal
authors.initials: AK
authors.lastname: Tuygun
authors.forename: Ahmet Yavuz
authors.initials: AY
authors.lastname: Balci
authors.forename: Sinan
authors.initials: S
authors.lastname: Sahin
authors.forename: Ilyas
authors.initials: I
authors.lastname: Kayacioglu
authors.forename: Pinar
authors.initials: P
authors.lastname: Alkan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yekeler
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D015505:Chest Tubes; D001026:Coronary Artery Bypass / Q000379:methods*; D004322:Drainage; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000453:epidemiology / Q000209:etiology
chemical_list: D000700:Analgesics