“Pigtail” Catheter Drainage in Thoracic Surgery

Abstract

Small-bore percutaneous drainage catheters have been used extensively in the management of abdominal disorders and are gaining acceptance in thoracic problems. The records have been reviewed in 44 consecutive patients in whom 53 small-bore catheters were placed for thoracic disease, including empyema, 20; effusion, 9; pneumothorax, 10; lung abscess, 4; and mediastinal cyst, 1. Insertion was performed under fluoroscopy in 88%, computed tomography in 6%, and ultrasonography in 6%. Catheters ranged in size from 6.5F to 12F, but catheter size did not seem to influence outcome (p = 0.6). There was complete resolution of the problem in 75% (33 of 44) of the patients, although 20% of them required more than one catheter. Treatment was successful in all cases of lung abscess. These patients had been previously treated with standard medical therapy for 12 to 53 days without significant improvement in their clinical condition. Patients with empyema composed the largest group treated. Eighty percent (16 of 20) of them had a loculated (LOC) process. The LOC group appeared to have a slightly better success rate than did the non-LOC group (75 versus 50%, p = 0.33). When the catheters failed to resolve the problem (empyema, 6; chylous effusion, 1; malignant effusion, 3; and spontaneous pneumothorax, 1, either operation (9.1%) or a standard thoracostomy tube (13.6%) was required. The complications rate was 20%, but most of these were minor problems including pneumothorax, 5; catheter occlusion 3; fractured catheter, 1; infection, 1; and significant subcutaneous emphysema, 1.(ABSTRACT TRUNCATED AT 250 WORDS)

The role of thoracoscopy in management and outcome of stage II thoracic parapneumonic empyema: review of 148 cases

“…The success rate of drainage by chest tube as the first procedure for the management of empyema is low [21][22][23][24]. In our study, 72 patients (47 %) underwent other procedures such as second chest tube, VATS, or thoracotomy.…”

CT-guided Percutaneous Pigtail Catheter Drainage and Normal Saline Irrigation for Treatment of Loculated Empyema

“…Multiple loculations may require multiple catheters for adequate drainage. 10 The presence of thick fibrous peel of chronic empyema is not a contraindication to initial percutaneous pigtail catheter drainage and has been used with some success after failure of stiff tube thoracostomy. 10 Image-guided approaches using CT, sonography, or fluoroscopy ensures proper catheter placement, and is successful in a high percentage of cases.…”

Implication of pigtail catheter vs chest tube drainage

“…2 For drainage of pleural collections, two drainage systems are commonly utilized: chest tube drainage and pigtail catheter drainage. 3,4 Each of them has its own indications, advantages, and disadvantages. The aim of this article is to provide a review on both systems, and to compare the reported safety, efficacy, and complications of each.…”

“…It is beneficial for drainage of non-viscid non-coagulable collections such as urine, pancreatic secretions, biliary secretions, or even air. 4 Pigtail catheter drainage is performed through ultrasoundguided transcutaneous insertion of the catheter into the target fluid collection. 5 The catheter is then fixed to the skin with sutures, and the other tip is sometimes put under water seal in certain condition such as drainage of pneumothorax.…”