Early and Effective Drainage of Tubercular Pleural Effusion Via Pigtail Cathetera Descriptive Study

Abstract

Background and Objectives. ABSTRACT Tube thoracostomy is used for therapeutic removal of fluid or air from pleural space. Placement of a large bore chest tube is an invasive procedure with potential morbidity and complications include hemothorax, perforation of intra- abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema and Horner’s syndrome and therefore the use of pigtail catheter may be desirable. Tuberculous pleurisy can result in obvious clinical symptoms, pleural fibrosis, and pleural thickening. Some studies of tuberculous pleurisy have suggested that symptomatic improvement and minimisation of sequelae can be achieved by completely draining the effusion during treatment, although the results have not been conclusive and the objective was to evaluate the early and effective drainage of tuberculous pleural effusion via pigtail catheter and to evaluate the radiological response in the improvement of pleural effusion after pigtail catheter insertion Methodology. The present study was conducted in the Department of Surgery K.L.E.S Dr. Prabhakar Kore Hospital and Medical Research Centre , Belgaum on 40 patients diagnosed as tubercular pleural effusion between Nov 2008 to Nov 2009. Pre and post insertion chest radiographs are reviewed to determine efficacy of drainage. The patients were treated as per hospital protocols. They were followed up for 6 months. The outcome variables like amount of fluid drained, total duration of hospitalization, level of radiological resolution, RPT as assessed by chest x-ray, and complications were noted XIV Results: There were 27 males & 13 females in the study. 60% of patients were above age group of 35,the mean amount of pleural fluid drained was 2575 ml, the mean duration of pigtail catheter was 4.5 days, the mean duration of hospitalization was 6 days, radiological resolution was clear in 75 % patients ( during discharge ) and minimal complications like chest pain ( 7.5% ) , pneumothorax ( 5% ) , tube blockade ( 7.5% ) were seen and at the six months of ATT residual pleural thickening was seen in 50 % of cases. Conclusion. Early effective drainage and complete ATT with pigtail catheter hasten clearance of pleural effusion and is safe, efficacious, comfortable, decreased hospital stay, cost-effective, minimal complications and improves patient quality of life and does not reduce residual pleural thickening occurence.