1,802 results match your criteria Tube Thoracostomy


The effects of analgesic treatment and chest physiotherapy on the complications of the patients with rib fractures that arise from blunt chest trauma.

Ulus Travma Acil Cerrahi Derg 2020 Jun;26(4):531-537

Department of Thoracic Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey.

Background: This prospective study aims to investigate the effect of chest physiotherapy and analgesic therapy on the possible complications of isolated rib fractures attributable to blunt thoracic trauma, such as hemothorax and pneumothorax.

Methods: Patients who presented to Çanakkale Onsekiz Mart University School of Medicine Hospital's Emergency Department and Thoracic Surgery outpatient clinics within the first 24 hours of the post-traumatic period and did not have additional intrathoracic complications at presentation with blunt thoracic trauma and who were diagnosed with isolated rib fractures were enrolled in this prospective research study. The groups were designated as the patients who would receive analgesic treatment only (Group A) and the patients who would receive chest physiotherapy and analgesic treatment together (Group B). Read More

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http://dx.doi.org/10.14744/tjtes.2019.26356DOI Listing

The results and outcome of primary spontaneous pneumothorax in adolescents.

Int J Adolesc Med Health 2020 Jun 7. Epub 2020 Jun 7.

Department of Pediatric Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

Aim Primary spontaneous pneumothorax (PSP) is a rare pulmonary pathology that occurs in the absence of known lung disease. A retrospective study was performed to evaluate the results and outcome of PSP treatment in adolescents. Methods The cases with PSP from January 2004 to December 2017 were evaluated for age, sex, family and smoking history, clinical and radiological findings and results of treatment. Read More

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http://dx.doi.org/10.1515/ijamh-2018-0184DOI Listing

Safe chest tube placement in a patient with tension pneumothorax receiving rivaroxaban therapy for non-valvular atrial fibrillation.

Monaldi Arch Chest Dis 2020 Jun 12;90(2). Epub 2020 Jun 12.

Emergency Department; Azienda Ospedaliero-Universitaria Pisana, Pisa University Hospital, Italy.

The number of patients treated with direct oral anticoagulants is increasing worldwide. Although bleeding complications associated with direct oral anticoagulants are lower than those associated with vitamin K antagonists, the increased number of patients treated with these anticoagulants suggests that a higher absolute number of patients are at risk. Tube thoracostomy is an invasive procedure with a high risk of bleeding. Read More

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http://dx.doi.org/10.4081/monaldi.2020.1262DOI Listing

Radiologically Guided Management of Secondary Spontaneous Pneumothorax.

Radiol Case Rep 2020 Jul 20;15(7):1115-1118. Epub 2020 May 20.

Thoracic Surgery Division, Department of Surgery, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Secondary spontaneous pneumothorax is a serious medical condition that typically occurs in patients with an underlying lung pathology such as chronic obstructive pulmonary disease. Those patients are usually compromised and more amenable to higher morbidity and mortality rates. Moreover, they are poor candidates for general anesthesia and mechanical ventilation due to their poor health condition. Read More

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http://dx.doi.org/10.1016/j.radcr.2020.02.039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283950PMC

Safety of the anterior approach versus the lateral approach for chest tube insertion by residents treating spontaneous pneumothorax: a propensity score weighted analysis.

Gen Thorac Cardiovasc Surg 2020 Jun 9. Epub 2020 Jun 9.

Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.

Objective: To compare the risk of chest tube malposition, the most common complication during chest tube insertion, with the anterior or lateral approach for thoracostomy performed for patients with spontaneous pneumothorax by junior and senior residents.

Methods: We retrospectively included patients aged ≥ 20 years who exhibited primary or secondary spontaneous pneumothorax without pleural adhesion and underwent chest tube drainage performed by junior or senior residents at tertiary care hospital. The study exposure involved insertion of the chest tube in the midclavicular line (anterior approach) or the anterior or midaxillary line (lateral approach). Read More

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http://dx.doi.org/10.1007/s11748-020-01403-5DOI Listing

Concealment of trauma and occupational accidents among Fukushima nuclear disaster decontamination workers: A case report.

J Occup Health 2020 Jan;62(1):e12123

Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.

Objectives: Limited information exists concerning occupational risks in decontamination work after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Workers involved tend to be migrant workers, face various health risks, and are usually from a low socioeconomic background and generally have difficulty in finding employment. We report a specific case to illustrate the way these workers tend to get injured during working hours and draw attention to the problems arising. Read More

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http://dx.doi.org/10.1002/1348-9585.12123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199476PMC
January 2020

Bilio-thorax: an unrecognized complication of liver surgery.

Int J Surg Case Rep 2020 14;71:346-348. Epub 2020 May 14.

The Cancer Foundation Hospital, Karachi, Pakistan. Electronic address:

Introduction: Although a rare complication, Biliothorax, or chole-thorax as it has been called in literature, is a devastating entity if not recognized early. Various causes have been reported for biliothorax like inflammatory, abdominal trauma, neoplastic, the most frequent being percutaneous hepatic intervention.

Case: We present the case of a 60 year old male, treated for colon cancer, who developed this complication after liver surgery. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.04.080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270503PMC

Primary repair of esophageal perforation: Case report.

Int J Surg Case Rep 2020 11;71:159-162. Epub 2020 May 11.

Department of Surgery and Anesthesiology, Moi University, School of Medicine, Eldoret, Kenya; Department of Cardiothoracic Surgery, Moi Teaching and Referral Hospital, Eldoret, Kenya.

Introduction: Mortality after esophageal perforation is high irrespective of the treatment modality. The rarity of traumatic esophageal perforations has made it difficult to conduct comprehensive studies that can answer pertinent questions with regard to management.

Presentation Of Case: We report a case of through and through thoracic esophageal injury caused by an assailant's arrow in a young physically active male adult. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.04.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7248577PMC

Exposure and Confidence With Critical Nonairway Procedures: A Global Survey of Pediatric Emergency Medicine Physicians.

Pediatr Emerg Care 2020 May 19. Epub 2020 May 19.

Paediatric Research in Emergency Departments International Collaborative.

Background: Children rarely experience critical illness, resulting in low exposure of emergency physicians (EPs) to critical procedures. Our primary objective was to describe senior EP confidence, most recent performance, and/or supervision of critical nonairway procedures. Secondary objectives were to compare responses between those who work exclusively in PEM and those who do not and to determine whether confidence changed for selected procedures according to increasing patient age. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002092DOI Listing

Intrapleural Fibrinolytic Therapy versus Early Medical Thoracoscopy for Treatment of Pleural Infection: Randomized Clinical Trial.

Ann Am Thorac Soc 2020 May 18. Epub 2020 May 18.

Beth Israel Deaconess Medical Center, 1859, Division of Thoracic Surgery and Interventional Pulmonology, Boston, Massachusetts, United States;

Rationale: Pleural infection is a frequent diagnosis encountered in clinical practice associated with high morbidity and mortality. Limited evidence exists regarding the optimal treatment. Although both early medical thoracoscopy (MT) and tube thoracostomy with intrapleural instillation of tissue plasminogen activator (tPA) and human recombinant deoxyribonuclease (DNase) are acceptable treatment for patients with complicated pleural infection, there is a lack of comparative data between these modes of management. Read More

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http://dx.doi.org/10.1513/AnnalsATS.202001-076OCDOI Listing

Blunt trauma related chest wall and pulmonary injuries: An overview.

Chin J Traumatol 2020 Jun 20;23(3):125-138. Epub 2020 Apr 20.

Gulhane Medical School, University of Health Sciences, Ankara, Turkey.

Physical traumas are tragic and multifaceted injuries that suddenly threaten life. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Blunt injuries constitute the majority of chest trauma. Read More

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http://dx.doi.org/10.1016/j.cjtee.2020.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296362PMC

Tube thoracostomy during the COVID-19 pandemic: guidance and recommendations from the AAST Acute Care Surgery and Critical Care Committees.

Trauma Surg Acute Care Open 2020 30;5(1):e000498. Epub 2020 Apr 30.

Department of Surgery, Inova Fairfax Medical Center, Falls Church, Virginia, USA.

This document provides guidance for trauma and acute care surgeons surrounding the placement, management and removal of chest tubes during the COVID-19 pandemic. Read More

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http://dx.doi.org/10.1136/tsaco-2020-000498DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213907PMC

Sonogram of safety: Ultrasound outperforms the fifth intercostal space landmark for tube thoracostomy site selection.

J Clin Ultrasound 2020 Jul 25;48(6):303-306. Epub 2020 Apr 25.

Department of Emergency Medicine, Michigan Medicine, Ann Arbor, Michigan, USA.

Purpose: Identification of tube thoracostomy insertion location is currently performed using a blind, landmark based approach at either the fifth intercostal space (ICS) or inframammary crease in the midaxillary line. A significant percentage of thoracostomies at this site result in complications. This pilot study aimed to assess whether bedside ultrasound could aid in identifying safer tube thoracostomy insertion sites in emergency department patients. Read More

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http://dx.doi.org/10.1002/jcu.22851DOI Listing

A CARE-compliant article: a case report of pleural empyema secondary to Klebsiella pneumoniae liver abscess with a hepatopleural fistula.

Medicine (Baltimore) 2020 Apr;99(16):e19869

Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Jung-gu, Incheon, South Korea.

Introduction: Klebsiella pneumoniae liver abscess (KPLA) is often associated with accompanying metastatic complications such as septic pulmonary embolism, brain abscess, and endophthalmitis. Pleural empyema secondary to a KPLA is a very unusual finding, made even more rare with the presence of a hepatopleural fistula.

Patient Concerns: An 81-year-old woman presented with aggravated dyspnea. Read More

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http://dx.doi.org/10.1097/MD.0000000000019869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220185PMC

How emergency physicians choose chest tube size for traumatic pneumothorax or hemothorax: a comparison between 28Fr and smaller tube.

Nagoya J Med Sci 2020 Feb;82(1):59-68

Department of Traumatology and Critical Care Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.

Most traumatic pneumothoraxes and hemothoraxes can be managed non-operatively by means of chest tube thoracostomy. This study aimed to investigate how emergency physicians choose chest tube size and whether chest tube size affects patient outcome. We reviewed medical charts of patients who underwent chest tube insertion for chest trauma within 24 hours of admission in this retrospective, single-institution study. Read More

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http://dx.doi.org/10.18999/nagjms.82.1.59DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103871PMC
February 2020

Association Between Adherence to Evidence-Based Practices for Treatment of Patients With Traumatic Rib Fractures and Mortality Rates Among US Trauma Centers.

JAMA Netw Open 2020 Mar 2;3(3):e201316. Epub 2020 Mar 2.

Institute for Health Informatics, University of Minnesota Academic Health Center, Minneapolis.

Importance: Rib fractures are sustained by nearly 15% of patients who experience trauma and are associated with significant morbidity and mortality. Evidence-based practice (EBP) rib fracture management guidelines and treatment algorithms have been published. However, few studies have evaluated trauma center adherence to EBP or the clinical outcomes of each practice within a national cohort. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2020.1316DOI Listing

Occult Pneumothorax in Patients Presenting with Blunt Chest Trauma: An Observational Analysis.

Qatar Med J 2020 16;2020(1):10. Epub 2020 Mar 16.

Department of Surgery, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar.

We aimed to assess the management and outcome of occult pneumothorax and to determine the factors associated with failure of observational management in patients with blunt chest trauma (BCT). Patients with BCT were retrospectively identified from the trauma database over 4 years. Data were analyzed and compared on the basis of initial management (conservative vs. Read More

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http://dx.doi.org/10.5339/qmj.2020.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075257PMC

Viscum pleurodesis is as effective as talc pleurodesis and tends to have less adverse effect.

Support Care Cancer 2020 Mar 12. Epub 2020 Mar 12.

Department of Thoracic and Cardiovascular Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Purpose: Many patients diagnosed with advanced cancer have malignant pleural effusion that does not respond to chemotherapy or radiation therapy. These patients often have respiratory symptoms, especially dyspnea. In order to relieve these symptoms, various procedures including chemical pleurodesis have been performed. Read More

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http://dx.doi.org/10.1007/s00520-020-05405-0DOI Listing

Treatment of persistent air leak with endobronchial valves.

Adv Respir Med 2020 ;88(1):27-29

Department of Respiratory Diseases, AZ Delta Roeselare, Roeselare, Belgium.

Persistent pulmonary air leaks are usually treated conservatively with prolonged thoracostomy tube drainage. In case this approach fails, surgical revision used to be the only option. This case report describes the successful treatment of a 66-year old patient who developped a pulmonary air leak after cardiothoracic surgery that persisted despite attempted surgical repair and talc pleurodesis. Read More

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http://dx.doi.org/10.5603/ARM.a2020.0075DOI Listing
January 2020

Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization.

Am J Case Rep 2020 Mar 8;21:e920196. Epub 2020 Mar 8.

Department of Surgery, Kendall Regional Medical Center, Miami, FL, USA.

BACKGROUND Thyrocervical trunk pseudoaneurysms are rare complications that have been documented after internal jugular or subclavian venous cannulation. Even less common, these pseudoaneurysms can arise after blunt or penetrating trauma. Clinical hallmarks include an expanding supraclavicular mass with local compressive symptoms such as paresthesias, arterial steal syndrome, and Horner's syndrome. Read More

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http://dx.doi.org/10.12659/AJCR.920196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081952PMC

A delayed and recurrent pneumothorax complicating a fractured clavicle - A novel presentation.

Trauma Case Rep 2020 Apr 25;26:100294. Epub 2020 Feb 25.

Community Mental Health, Trelawny Health Services, Western Regional Health Authority, 1S, Montego Bay, St. James, Jamaica.

There are very few reports in the literature about clavicular fractures being associated with a pneumothorax. With this combination of injuries, there are also minimal reports of a delayed presentation of a pneumothorax. This is the first report of a delayed pneumothorax followed by a recurrence of a pneumothorax due to the fractured ends of the clavicle. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044753PMC

Differences in quality of life outcomes after paraclavicular decompression for thoracic outlet syndrome.

J Vasc Surg 2020 Feb 27. Epub 2020 Feb 27.

Division of Vascular Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif.

Background: Thoracic outlet syndrome (TOS) results from compression of the neurovascular structures in the thoracic outlet. Decompression provides relief of TOS symptoms. However, little is known about long-term function and quality of life (QoL) from a patient's perspective. Read More

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http://dx.doi.org/10.1016/j.jvs.2019.12.037DOI Listing
February 2020
3.021 Impact Factor

Hemothorax resulting from an initially masked aortic perforation caused by penetration of the sharp edge of a fractured rib: A case report.

Int J Surg Case Rep 2020 13;68:18-21. Epub 2020 Feb 13.

Department of Thoracic Surgery, Otsu Red Cross Hospital, Shiga, Japan. Electronic address:

Introduction: There are multiple causes of hemothorax in blunt chest trauma. However, a traumatic hemothorax with an uncertain cause is potentially life-threatening without treatment, because an undetected and hidden great vessel injury can remain unknown. Delayed diagnosis can lead to death. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.02.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044492PMC
February 2020

Quantitative measurement of air leak in patients with chest drains.

Turk Gogus Kalp Damar Cerrahisi Derg 2019 Jan 1;27(1):80-87. Epub 2019 Jan 1.

Department of Cardiovascular Surgery, Ege University School of Medicine, İzmir, Turkey.

Background: This study aims to evaluate a new method that detects peak air leak speed and peak air leak flow, investigate the correlation between the amount of air leak and development of prolonged air leak, and identify patients who are at risk of developing prolonged air leak after lung resection.

Methods: In this prospective trial, the amount of air leak was measured with the assistance of an anemometer connected to the top of a standard underwater drainage system, and a mobile phone with android operating system. Patients who underwent tube thoracostomy for spontaneous pneumothorax were assigned to group 1 (18 males, 1 female; mean age 31. Read More

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http://dx.doi.org/10.5606/tgkdc.dergisi.2019.16735DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021370PMC
January 2019

Routine Chest X-Rays After Thoracic Surgery Are Unnecessary.

J Surg Res 2020 Jun 17;250:188-192. Epub 2020 Feb 17.

Department of Surgery, Section of Thoracic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

Background: Routine chest x-rays (CXRs) ordered on thoracic surgery inpatients are common, costly, and of unclear clinical utility. We sought to investigate CXR ordering practices and their impact on clinical care.

Materials And Methods: A single-center, retrospective cohort study of adult patients admitted after undergoing thoracic surgery with an intraoperative chest tube (CT) placed was performed over a 1-y period. Read More

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http://dx.doi.org/10.1016/j.jss.2019.12.030DOI Listing

A Hidden Complication of Pigtail Catheter Insertion.

Clin Pract Cases Emerg Med 2020 Feb 21;4(1):90-91. Epub 2020 Jan 21.

São Paulo University, Department of Emergency Medicine, São Paulo, Brazil.

Pigtail catheters have emerged as an effective and less morbid alternative to traditional chest tubes for evacuation of pleural air. Rare complications in the literature have been reported. We report a case of a 92-year-old male who presented with dyspnea and shock, noted to have a pneumothorax requiring tube thoracostomy. Read More

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http://dx.doi.org/10.5811/cpcem.2019.11.44913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012549PMC
February 2020

Serratus Anterior Plane Block in the Emergency Department: A Case Series.

Clin Pract Cases Emerg Med 2020 Feb 21;4(1):21-25. Epub 2020 Jan 21.

Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York.

This is a case series of six emergency department (ED) patients who received an ultrasound-guided serratus anterior plane block (SAPB) for a variety of painful conditions. Our cases illustrate the feasibility and analgesic efficacy of the SAPB in providing pain management in ED patients with a variety of painful syndromes, including those with severe pain from multiple rib fractures, herpes zoster, and tube thoracostomy placement. In addition, we found no adverse events in our case series. Read More

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http://dx.doi.org/10.5811/cpcem.2019.11.44946DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012558PMC
February 2020

The Evolution of Surgical Management for Children and Young Adults With Spontaneous Pneumothorax.

J Surg Res 2020 Jun 7;250:135-142. Epub 2020 Feb 7.

Division of Pediatric Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.

Background: Few studies have analyzed pediatric spontaneous pneumothorax (SPTX) nationally. We sought to better define this patient population and explore the evolution of surgical management.

Methods: Patients (10-20 y old) with an International Classification of Diseases, Ninth Revision diagnosis of SPTX were identified within the Kids' Inpatient Database for the years 2006, 2009, and 2012. Read More

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http://dx.doi.org/10.1016/j.jss.2019.12.032DOI Listing

Variability of presentation and surgical approach in Congenital Cystic Lesions of Lung: A retrospective study in children presenting in Mayo Hospital.

J Pak Med Assoc 2019 Jul;69(7):1035-1038

Department of Plastic surgery, King Edward medical university, Lahore.

The objective was to study the clinical presentation and surgical outcome in children with congenital cystic lesions of the lung. The medical records of 11 patients operated in the department of paediatric surgery, from January 2014 to December 2017, were evaluated retrospectively. Median age was 18 months (1-108). Read More

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Novel tube thoracostomy device reduces incision length.

Am J Emerg Med 2020 Jan 17. Epub 2020 Jan 17.

Emergency Medicine PA-C, DSc, Joint Base Elmendorf-Richardson, AK 99506, United States of America.

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http://dx.doi.org/10.1016/j.ajem.2020.01.022DOI Listing
January 2020

Declining frequency of thoracoscopic decortication for empyema - redefining failure after fibrinolysis.

J Pediatr Surg 2020 Jan 10. Epub 2020 Jan 10.

Department of Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA; School of Medicine, University of Missouri-Kansas City, 2411 Holmes St, Kansas City, MO 64108, USA. Electronic address:

Background: Primary fibrinolysis for pediatric empyema has become standard of care at our institution. Early study of our protocol revealed a 16% thoracoscopic decortication rate after primary fibrinolysis. We now report the frequency with which children progress to operation with maturation of the protocol. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2019.12.023DOI Listing
January 2020
1.311 Impact Factor

Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage.

Am J Surg 2020 Aug 8;220(2):476-481. Epub 2020 Jan 8.

Department of Surgery, University of California, Davis, USA; Department of Surgery Outcomes Research Group, University of California, Davis, USA. Electronic address:

Background: There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures.

Methods: We conducted a retrospective cohort study of trauma patients who underwent tube thoracostomy during 2009-2015. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2020.01.007DOI Listing

A University Hospital Based Study on Thoracic Trauma: Life Threatening Event, Its Etiology, Presentation, and Management.

Cureus 2019 Dec 6;11(12):e6306. Epub 2019 Dec 6.

Anatomy, Quetta Institute of Medical Sciences, Quetta, PAK.

Introduction: Thoracic injury is becoming an important cause of mortality in Pakistan, especially in the younger subset of population. The initial management of these injuries is essential as these patients can develop multiple complications, ultimately leading to death of the patients.

Materials And Methods: This prospective observational study was carried out from January 2016 to December 2018 at the Department of Surgery, Holy Family Hospital, Rawalpindi Medical University, Pakistan. Read More

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http://dx.doi.org/10.7759/cureus.6306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944145PMC
December 2019

Needle Aspiration Versus Closed Thoracostomy in the Treatment of Spontaneous Pneumothorax: A Meta-analysis.

Lung 2020 Apr 11;198(2):333-344. Epub 2020 Jan 11.

Department of Emergency & Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Purpose: To compare the effectiveness and safety between needle aspiration (NA) and closed thoracostomy (CT) method in adult spontaneous pneumothorax (SP) patients and to explore the most effective and safe protocol by using meta-analysis method.

Materials And Methods: This study was based on Cochrane methodology for conducting meta-analysis. Only randomized controlled trials were eligible for this study. Read More

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http://dx.doi.org/10.1007/s00408-020-00322-9DOI Listing

Silicosis with Bilateral Spontaneous Pneumothorax in Rajasthan.

Indian J Occup Environ Med 2019 Sep-Dec;23(3):112-116. Epub 2019 Dec 16.

Department of Chest and TB, Institute of Respiratory Disease, SMS Medical College, Jaipur, Rajasthan, India.

Background And Aims: Silicosis is an occupational lung disease caused by inhalation of crystalline silica. People working in occupations like sandblasting, surface drilling, tunnelling, silica flour milling, ceramic making are predisposed to develop silicosis. Unilateral spontaneous pneumothorax is a pleural complication that can develop in such cases. Read More

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http://dx.doi.org/10.4103/ijoem.IJOEM_247_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6941338PMC
December 2019

Efficacy of a Novel Surgical Manikin for Simulating Emergency Surgical Procedures.

Am Surg 2019 Dec;85(12):1318-1326

From the *Discipline of Trauma Surgery, Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.

The practical component of the Advanced Trauma Life Support (ATLS®) course typically includes a TraumaMan® manikin. This manikin is expensive; hence, a low-cost alternative (SurgeMan®) was developed in Brazil. Our primary objective was to compare user satisfaction among SurgeMan, TraumaMan, and porcine models during the course. Read More

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December 2019

Endovascular Thoracic Aortic Repair for Catheter Associated Aortic Injury During Thoracostomy Tube Placement.

EJVES Short Rep 2020 9;46:2-4. Epub 2019 Dec 9.

Stony Brook University Medical Center, Department of Surgery, Division of Vascular and Endovascular Surgery, Stony Brook, NY, USA.

Background: Aortic injuries during non-aortic related procedures are rare but potentially catastrophic. Endovascular aortic repair has been described as a viable option in similar circumstances. However, most reports involve aortic injury from orthopaedic hardware after spine surgery or trocar injury during abdominal surgery. Read More

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http://dx.doi.org/10.1016/j.ejvssr.2019.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920331PMC
December 2019

Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report.

Surg Case Rep 2019 Dec 11;5(1):195. Epub 2019 Dec 11.

Department of Esophageal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

Background: Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Read More

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http://dx.doi.org/10.1186/s40792-019-0709-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906276PMC
December 2019

Helicopter transport in pediatric trauma: A new methodology using Need for Surgeon Presence to evaluate the necessity of air transport.

Am J Surg 2020 Aug 29;220(2):464-467. Epub 2019 Nov 29.

Nemours Specialty Care Children's Clinic, Jacksonville, FL, USA. Electronic address:

Background: When to transport pediatric trauma patients directly from scene to a trauma center via helicopter (HT) has been a long debated topic. This study proposes Need for Surgeon Presence (NSP) matrix as an alternative method to assess appropriate utilization of HT of pediatric trauma patients directly from the scene of injury.

Method: We utilized the 2016 TQIP database. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.11.034DOI Listing

A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL).

J Trauma Acute Care Surg 2020 Feb;88(2):249-257

From the Department of Surgery, Division of Trauma, Denver Health Medical Center (F.M.P., K.L.), Denver Colorado; Department of Surgery, Division of Trauma, University of Nebraska Medical Center (Z.B.), Omaha, Nebraska; Department of Surgery, Division of Trauma, Medical University of South Carolina (E.A.E.), Charleston, South Carolina; Department of Surgery, Division of Trauma, St. Mary's Medical Center (L.L.), West Palm Beach, Florida; Department of Surgery, Division of Trauma, Intermountain Medical Center (S.M.), Murray, Utah; Department of Surgery, Division of CT Surgery, St. Joseph Health (L.P.), Mission Hospital, Mission Viejo, California; Department of Surgery, Division of Trauma, George Washington University (B.S.), Washington, District of Columbia; Department of Surgery, Division of Trauma, Wright State University/Miami Valley Hospital (G.S.), Dayton, Ohio; Department of Surgery, Division of Trauma, Carolinas Medical Center (B.T.), Charlotte, North Carolina; Department of Surgery, Division of Trauma, The Queens Medical Center (F.Z.), Honolulu, Hawaii; Department of Surgery, Division of Trauma, Sanford Health (C.D.), Fargo, North Dakota; Department of Surgery, Division of Trauma, Baystate Medical Center (A.R.D.), Springfield, Massachusetts.

Background: The efficacy of surgical stabilization of rib fracture (SSRF) in patients without flail chest has not been studied specifically. We hypothesized that SSRF improves outcomes among patients with displaced rib fractures in the absence of flail chest.

Methods: Multicenter, prospective, controlled, clinical trial (12 centers) comparing SSRF within 72 hours to medical management. Read More

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http://dx.doi.org/10.1097/TA.0000000000002559DOI Listing
February 2020

Does simulation work? Monthly trauma simulation and procedural training are associated with decreased time to intervention.

J Trauma Acute Care Surg 2020 Feb;88(2):242-248

From the Division of Acute Care Surgery, Department of General Surgery (C.P., J.G., R.D., L.D., T.S., D.J.S., S.L., K.A., M.C.), University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Establishing proficiency in specific trauma procedures during surgical residency has been limited to annual courses with limited data on its effect on the delivery of health care and patient outcomes. There is a wide variety of training on content and complexity with recent studies looking at time to imaging or secondary survey. In this study, we implement monthly case-based simulation after initial training on a variety of bedside trauma procedures. Read More

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http://dx.doi.org/10.1097/TA.0000000000002561DOI Listing
February 2020

Presumptive antibiotics in tube thoracostomy for traumatic hemopneumothorax: a prospective, Multicenter American Association for the Surgery of Trauma Study.

Trauma Surg Acute Care Open 2019 4;4(1):e000356. Epub 2019 Nov 4.

Department of Surgery, Broward Health, Fort Lauderdale, Florida, USA.

Background: Thoracic injuries are common in trauma. Approximately one-third will develop a pneumothorax, hemothorax, or hemopneumothorax (HPTX), usually with concomitant rib fractures. Tube thoracostomy (TT) is the standard of care for these conditions, though TTs expose the patient to the risk of infectious complications. Read More

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http://dx.doi.org/10.1136/tsaco-2019-000356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861092PMC
November 2019

Is routine chest radiography after ultrasonography-guided catheter thoracostomy necessary?

Singapore Med J 2019 Dec 2. Epub 2019 Dec 2.

Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.

Introduction: Many institutions still perform routine chest radiographs after tube thoracostomies despite current guidelines suggesting that this is not necessary for simple cases. We aimed to evaluate the usefulness of routine chest radiography following ultrasonography-guided catheter thoracostomies for the detection of complications of symptomatic pleural effusions in hospitalised patients.

Methods: This was a retrospective review of 2,032 ultrasonography-guided thoracostomies on hospitalised patients with symptomatic effusions at a single institution from April 2012 to May 2015. Read More

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http://dx.doi.org/10.11622/smedj.2019154DOI Listing
December 2019
0.634 Impact Factor

Operative Management of Thoracic Gunshot Wounds: More Aggressive Treatment Has Been Required over Time.

Am Surg 2019 Nov;85(11):1205-1208

Our department has a database of thoracic gunshot wounds (GSWs), which has cataloged these injury patterns over the past five decades. Prevailing wisdom on the management of these injuries suggested operative treatment beyond tube thoracostomy is not commonly required. It was our clinical impression that the operative treatment required beyond chest tube placement has greatly increased over the past several decades, whereas the operative management of cardiac GSWs seemed to be increasingly infrequent events. Read More

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November 2019

Arrow to the Chest.

Clin Pract Cases Emerg Med 2019 Nov 21;3(4):327-328. Epub 2019 Oct 21.

Jigme Dorji Wangchuck National Referral Hospital, Department of Emergency Medicine, Thimphu, Bhutan.

A 33-year-old male was brought to the emergency department after a penetrating arrow injury to the chest. Initial evaluation revealed the arrow was penetrating the sternum, lung, and aortic arch. Because the patient was in a remote area, timely transfer to a specialized center for definitive operative repair was delayed approximately 24 hours. Read More

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http://dx.doi.org/10.5811/cpcem.2019.9.43991DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861027PMC
November 2019

So you need a surgeon? Need for surgeon presence as an alternative metric to predict outcomes and assess triage in the pediatric trauma population.

J Pediatr Surg 2019 Nov 9. Epub 2019 Nov 9.

Nemours Children's Specialty Care Jacksonville, FL.

Background: Injury Severity Score (ISS) is the primary metric by which triage has been evaluated in trauma activations. We compared ISS to a previously described set of criteria defined as Need for Surgical Presence (NSP). We hypothesize that NSP may serve as a way to augment ISS in predicting mortality and assessing triage in pediatric trauma patients. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2019.10.055DOI Listing
November 2019

Chest Tube Insertion Among Surgical and Nonsurgical Trainees: How Skilled Are Our Residents?

J Surg Res 2020 03 21;247:344-349. Epub 2019 Nov 21.

Division of General Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University London Health Sciences Centre, East London, Ontario, Canada; Division of Critical Care Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, Western University London Health Sciences Centre, East London, Ontario, Canada; Trauma Program, London Health Sciences Centre, East London, Ontario, Canada.

Background: Competency-based medical education has renewed focus on the attainment and evaluation of resident skill. Proper evaluation is crucial to inform educational interventions and identify residents in need of increased training and supervision. Currently, there is a paucity of studies rigorously evaluating resident chest tube insertion skill. Read More

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http://dx.doi.org/10.1016/j.jss.2019.10.010DOI Listing

Bronchial artery laceration and haemothorax complicating transbronchial needle aspiration.

Respirol Case Rep 2020 Jan 7;8(1):e00497. Epub 2019 Nov 7.

Department of Medicine University of Maryland School of Medicine Baltimore MD USA.

A 74-year-old woman presented with chest pain and dyspnoea following endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) for presumed malignancy. Computed tomography angiography revealed a left-sided pleural effusion with hypertrophied and tortuous bronchial arteries (BAs) with contrast blush into the left lung hilum. Tube thoracostomy and pleural fluid analysis confirmed the diagnosis of haemothorax. Read More

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http://dx.doi.org/10.1002/rcr2.497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837855PMC
January 2020

Incidence and significance of injuries on secondary CT imaging after initial selective imaging in blunt trauma patients.

Am J Emerg Med 2019 Sep 11:158432. Epub 2019 Sep 11.

Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ, Department of Emergency Medicine, United States of America.

Objective: It is unclear if additional computerized tomography (CT) imaging is warranted after injuries are identified on CT in blunt trauma patients. The objective of this study was to determine the incidence and significance of injuries identified on secondary CT imaging after identification of injuries on initial CTs in blunt trauma patients.

Methods: This was a retrospective cohort study at an academic Level 1 trauma center with a two-tiered trauma system. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.158432DOI Listing
September 2019