Assessing the Safety and Effectiveness of Percutaneous Tube Thoracostomy Performed by Trainee Physicians: Insights from a Tertiary Academic Medical Center
DOI:
https://doi.org/10.61561/ssbgjms.v6i03.116Keywords:
Percutaneous tube thoracostomy, Trainee, TraumaAbstract
Background: Percutaneous tube thoracostomy is an essential procedure for treating pleural space diseases such as pneumothorax, hemothorax, and pleural effusion. While life-saving, it carries risks if not performed properly. In tertiary teaching hospitals, trainee doctors often perform this procedure under supervision. Evaluating their outcomes helps improve training and ensure patient safety.
Objectives: To evaluate the practice and outcomes of percutaneous tube thoracostomy performed by trainee doctors at a tertiary teaching hospital.
Materials and methods: This cross-sectional observational study was conducted in the Casualty Department of Dhaka Medical College Hospital from September 2024 to February 2025, with ethical approval. A total of 112 trauma patients aged above 15 years were included, excluding those with prior chest surgery, diabetes, trauma-related deaths, transfers after PTT, or age below 12 years. Data on demographics, procedural details of percutaneous tube thoracostomy, and post-procedural outcomes were collected and analyzed using SPSS version 25
Results: The study included 112 patients aged 17–61 years, with a mean age of 36.2 ± 11.8 years; the largest group was 31–40 years (35.5%), followed by 21–30 years (25%). Most percutaneous tube thoracostomies (82.1%) were performed within the recommended “safety triangle,” predominantly at the 5th intercostal space (48.2%). The commonly used tube sizes were 30Fr (46.4%), 28Fr (32.1%), and 32Fr (21.4%), with a mean incision length of 2.71 ± 0.54 cm. Post-procedure recovery was uneventful in 69.6% of patients, while 30.4% experienced complications, most commonly auto-expulsion/leakage (8%), haemorrhage (7.1%), wound infection (6.3%), subcutaneous emphysema (4.5%), and non-functioning tubes (4.5%).
Conclusion: Percutaneous tube thoracostomy carried out by trainee doctors in a tertiary teaching hospital is largely safe and effective. Most procedures followed standard practices, including correct placement within the safety triangle, appropriate tube size, and suitable incision length. Although most patients recovered without complications, a significant number experienced minor issues, underscoring the importance of proper training, supervision, and strict adherence to procedural protocols to maintain patient safety.
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