Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended. 1. Introduction Tube thoracostomy is the most commonly performed surgical procedure in thoracic surgery. As a life saving procedure, general surgeons, intensivists, emergency physicians, and respiratory physicians may at one time or the other be required to perform tube thoracostomy. The first documented description of a closed tube drainage system for the drainage of empyema was by Hewett in 1867 [1]. However during the Second World War, the experience gained in military and civilian hospitals contributed to the development of tube thoracostomy in chest trauma management, and, at the time of the Vietnam war, it has become the standard of care for management of chest trauma [2]. In 1992, Lilienthal reported the postoperative use of chest tube following lung resection for suppurative diseases of the lung [3]. Tube thoracostomy is an invasive procedure and complications can result due to inadequate knowledge of thoracic anatomy or inadequate training and experience. These complications can simply be classified as technical or infective. Trocar technique is by far associated with a higher rate of complication [4, 5]. 2. Methods A literature review on tube
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