thoracostomie

Thoracostomy is a medical procedure involving the creation of an opening in the chest wall to access the pleural cavity, typically performed to drain air, blood, pus, or other fluids. This procedure is commonly indicated in cases of pneumothorax (collapsed lung), hemothorax (accumulation of blood), pleural effusion, or empyema (infection).

The procedure can be performed as an emergent or elective measure, often using local anesthesia. A small incision is made, usually in the second or third intercostal space along the mid-axillary line, to insert a chest tube or drain. This tube allows for continuous removal of the pathological contents and helps re-expand the lung. Proper placement is critical to avoid injury to surrounding tissues and organs, including the diaphragm, blood vessels, and lungs.

Thoracostomy can be performed via two main techniques: closed (percutaneous) or open thoracostomy. The closed method involves inserting a drain without making a large incision, making it less invasive. Open thoracostomy, known as a thoracotomy, involves a surgical incision for more complex cases or when extensive access is required.

Post-procedure, patients are monitored closely for complications such as infection, bleeding, or re-expansion pulmonary edema. The duration of chest tube placement varies based on the underlying pathology and response to treatment.

Thoracostomy is a critical intervention in emergency and thoracic care, facilitating lung re-expansion and improving respiratory function. It is generally performed by trained healthcare professionals, including surgeons, pulmonologists, or emergency physicians.

References:

- Light, R. W. (2013). Pleural Diseases. Lippincott Williams & Wilkins.

- Cohn, A., & Cerfolio, R. J. (2004). Thoracostomy Tube Placement and Management. Current Treatment Options in Oncology.