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Tube Thoracostomy

Pleural mesothelioma is a serious type of cancer that necessitates a number of treatments in order to keep the patient as comfortable as possible. While most of these treatments do not provide the chance for a cure, they are indeed useful as palliative therapies, relieving some of the symptoms caused by the disease. One such treatment is the insertion of a chest tube (also known as a tube thoracostomy) which serves to drain fluid from the body’s pleural space.

What is a Tube Thoracostomy?

A tube thoracostomy is a thin, flexible plastic tube that is inserted into the pleural space through a small incision in the side of the chest. Sometimes called a Bülau drain or an intercostal catheter, the tube is used to drain fluid, air or pus from the pleural area. In cases of those with pleural mesothelioma, it is generally used to treat pleural effusion and eliminate the fluid that gathers around the lungs.

Today, the tubes are generally made of silicone, which is more flexible than the PVC that was once used. The opposite end of the tube is generally attached to a chest drainage canister device, which is an underwater seal that is positioned below the level of the chest. It allows the fluid to flow freely but blocks anything from returning to the chest.

The placement of the tube is generally not permanent. The procedure allows for drainage until a more permanent form of treatment is decided upon. Outside of the treatment of pleural mesothelioma, it is often used in emergency situations, especially when trauma occurs and thoracic injuries are present.

What to Expect

During the insertion of a tube thoracostomy, the patient lies down and a local anesthetic is used to numb the area where the tube will be inserted. Generally, an incision is made between the ribs on the side or front of the chest. A narrow track is made by means of a wire and the tube is then inserted into the pleural space. The tube will then be connected to the drainage system.

The tube usually remains in place until the fluid is drained. Some form of imaging, including a simple chest X-ray, may be used to monitor the success of the tube thoracostomy.

The patient will feel some pain at the insertion site and some will experience ongoing discomfort until the tube is removed. Others, however, do not exhibit ongoing pain but do indeed note the inconvenience of the chest tube. Complications from the placement of a tube thoracostomy include bleeding or infection.

If you would like to learn more about tube thoracostomy and other palliative treatment options for pleural mesothelioma, please fill out the request form on this page to receive a complimentary informational packet in the mail.

Sources:

1. http://emedicine.medscape.com/article/80678-overview