title: Technical validation of pulmonary drainage for the treatment of severe pulmonary emphysema: a cadaver-based study.
abstract: OBJECTIVE
  A cadaver-based study was carried out in order to describe the pulmonary drainage surgical technique, to determine whether the site for the insertion of the chest tube is appropriate and safe, and to determine the anatomical relationship of the chest tube with the chest wall, lungs, large blood vessels, and mediastinum.
  
  
  METHODS
  Between May and November of 2011, 30 cadavers of both genders were dissected. The cadavers were provided by the Santa Casa de São Paulo Central Hospital Mortuary, located in the city of São Paulo, Brazil. A 7.5-cm, 24 F steel chest tube was inserted into the second intercostal space along the midclavicular line bilaterally, and we measured the distances from the tube to the main bronchi, upper lobe bronchi, subclavian vessels, pulmonary arteries, pulmonary arteries in the upper lobe, superior pulmonary vein, azygos vein, and aorta. Weight, height, and chest wall thickness, as well as laterolateral and posteroanterior diameters of the chest, were measured for each cadaver.
  
  
  RESULTS
  Of the 30 cadavers dissected, 20 and 10 were male and female, respectively. The mean distance between the distal end of the tube and the main bronchi (right and left) was 7.2 cm (for both).
  
  
  CONCLUSIONS
  The placement of a fixed-size chest tube in the specified position is feasible and safe, regardless of the anthropometric characteristics of the patients.
authors.affiliation: Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil. mottlopez@uol.com.br
authors.forename: Júlio Mott Ancona
authors.initials: JM
authors.lastname: Lopez
authors.forename: Roberto
authors.initials: R
authors.lastname: Saad
authors.forename: Vicente
authors.initials: V
authors.lastname: Dorgan Neto
authors.forename: Marcio
authors.initials: M
authors.lastname: Botter
authors.forename: Roberto
authors.initials: R
authors.lastname: Gonçalves
authors.forename: Jorge Henrique
authors.initials: JH
authors.lastname: Rivaben
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D002102:Cadaver; D015505:Chest Tubes / Q000009:adverse effects*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000601:surgery*; D013909:Thorax / Q000033:anatomy & histology; D055815:Young Adult