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Objective:To evaluate the effectiveness of pigtail catheter applying in single port video assistant thoracic surgery(VATS) for pulmonary tumor.Methods:A total of 441 patients undergoing single port VATS were obtained in this study. The patients were divided into chest-tube group and pigtail-catheter group. We used propensity score matching to match the patients 1∶1 and the clinical factors of the two groups were compared.Results:There were 143 patients in each group successfully matched by propensity score matching. The total drainage of 3 days after operation of pigtail-catheter group was significantly more than chest-tube group(375.49 ml vs. 285.03 ml, P<0.001). The pleural effusion on CT scan two weeks after surgery of pigtail-catheter group was significantly less than chest-tube group(131.77 ml vs. 178.84 ml, P=0.032). There was no significant difference between the two groups for the pain score, drainage days and inpatient days. Conclusion:Pigtail catheter can effectively improve the drainage of single port VATS, and there was no influence for the advantage of the surgery.
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Liver abscess in pregnancy is a rare entity and can be a life threatening condition. Here we present A case of amoebic liver abscess in 25 years old lady in of pregnancy, with highlights on treatmentthird trimester difficulties which we had faced in the management and timely intervention leads to good fetomaternal outcome
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Background: Liver abscess (LA) is defined as an encapsulated collection of suppurative material within the liver parenchyma. Liver abscesses are most commonly due to bacterial, amoebic or mixed infections. Less commonly these may be fungal in origin. Liver abscess are associated with mortality of up to 20% and are categorized into various types based on aetiology, of which amoebic (ALA) and pyogenic (PLA) liver abscess are major types. The objective is to evaluate and assess the response of percutaneous pigtail catheter drainage in treatment of liver abscess and to document the complications of liver abscess (LA).Methods: The study was conducted on patients who were admitted from casualty and outpatient department with a diagnosis of liver abscess (LA). 100 patients of LA were included in the study. They were divided into two groups. Group 1 consists of LA patients without associated complications and Group 2 consists of LA patients with associated complications like rupture, jaundice, IVC compression, persistent or recurrent LA.Results: There were 88% males and 12% were females in the study. 30% patients had complications. Out of them, 14 (46.6%) patients of LA presented with intra-peritoneal rupture. 12 (40%) with jaundice, 2 (6.7%) with rupture into pleural cavity and 2 (6.7%) patients had IVC compression. (70%) had involvement of right lobe while minimum patients (12.9%) had bilateral lobe involvement in group 1 and (10%) had involvement of left lobe of liver in group 2.Conclusions: Pigtail insertion and percutaneous catheter drainage (PCD) of abscesses, peritoneal or pleural cavity are safe procedures. PCD is a good alternative to open surgical drainage.
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Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in India. Residual pleural thickening (RPT) is observed in about 50 percent of patients even after proper treatment with ATT. Pleural fluid drainage either with simple aspiration or with intercostal drainage and addition of corticosteroids along with antitubercular drugs have not shown to influence the incidence of RPT. The present study was undertaken to study the complications and residual effects of tubercular pleural effusion on the patients during the follow up period following intrapleural streptokinase instillation.Methods: Clinical profile, hospital course and outcome of tuberculous pleural effusion patients at the end of six months of anti-tubercular treatment of 50 patients from January 2009 to June 2010 were analyzed. These patients were randomly divided into two groups. One group (n=25) received intrapleural streptokinase via pigtail catheter and the other group (n=25) received intercostal drainage without intrapleural streptokinase instillation. All the patients received standard daily anti TB regimen of 2HERZ/4HR for a total duration of six months. All the patients were followed up for a total duration of 1 year for evidence of any residual pleural thickening.Results: Majority of the patients were above 40 years of age (60%). The male to female ratio was 2.3:1. The major symptoms of the patients were, fever in 44 patients (88%), cough in 42 patients (84%), breathlessness in 33 patients (66%), loss of appetite in 25 patients (50%) and chest pain in 25 patients (50%). Most of the patients had ADA levels between 40-70IU/L (48%) and only 6% had ADA levels below 40IU/L. The incidence of residual pleural thickening in the study group was less as compared to the control group (2.36�49mm vs 9.28�50mm) (p <0.0001).Conclusion: Intrapleural streptokinase instillation with pigtail catheter drainage less number of complications associated with study group and is successful with the decreased incidence of residual pleural thickening during the follow up period.
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Objective: The aim of this study was to compare the effectiveness of percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the management of hepatic abscess. Methods: The current study includes prospective randomized comparative study of 60 patients admitted in emergency and indoor department at tertiary health care centre, randomized into two groups- Percutaneous needle aspiration (PNA) & Pigtail catheter drainage (PCD). The effectiveness of hepatic abscess is based early recovery period, duration of hospital stay, and clinical improvement status. Results: The recovery rate was significantly improved in catheter drainage group. The analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of early recovery, clinical improvement and days to achieve a 50% reduction in abscess cavity size. Conclusion: Both PNA and PCD are safe methods of draining hepatic abscesses. However, PCD is more effective than PNA because it facilitates a higher success rate, reduces the time required to achieve clinical relief and supports a 50% reduction in abscess cavity size. However, among successfully treated patients, the outcomes of PNA are comparable with those of PCD.
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Objective To investigate the two kinds if thoracic cavity closed drainage contrast analysis and evaluate the pigtail catheter for treatment of spontaneous pneumothorax in adolescents.Methods This study included 53 adolescent patients with the first spontaneous pneumothorax in Huaihe Hospital of Henan University between January 2013 and December 2015.According to the different operation ways,they were divided into two groups:silicone tube and pigtail catheter group.The following post-operative data was evaluated:pain,subcutaneous emphysema,drainage time,hospital stay,new drain insertion,and wound healing at the site of insertion.Results There were 32 patients in the silicone tube group and 21 ones in the other group.The data revealed a significantly reduced the operation time and pain in the pigtail catheter group compared to the chest tube group(P ＜ 0.05).However,no statistical differences in success rate,postoperative hospital stay and complications incidence were found between the 2 groups.Conclusion Compared to common chest tube,the employment of pigtail catheter in the adolescent patients with pneumothorax significantly reduces the operation time and pain.Nevertheless,no statistically significant differences were discovered in success rate,postoperative hospital stay and the incidence of complications between the two corresponding groups.Thus pigtail catheter is competent in terms of closed thoracic drainage in adolescents who are the first diagnosed as spontaneous pneumothorax.
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Objective To explore the effect of pigtail and silicone catheters on thoracic close drainage. Methods Sixty-one patients undergoing closed thoracic drainage hospitalized in our department from June 2013 to November 2016 were divided into the control group (n=31) and observation group (n=30). The control group was treated with closed pleural drainage using silicone catheter and the observation group using pigtail catheter. The two groups were compared in respect of drainage effect nursed the same. Results The extubation time, wound healing time of the observation group were all significantly shorter than those of the control group ( P<0.05). The pain score, complication rate and hospitalization cost were all significantly lower as well ( P < 0.05). Conclusions The pigtail catheter is more effective in the treatment of pneumothorax. It can alleviate pains, reduce the complication rate and surgical scar, and improve patient's satisfaction.
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Background: Large liver abscess requires drainage by pigtail catheter. These catheters tend to get blocked frequently and thus takes long period of time to completely drain. So we wanted to study whether inserting a large bore catheter would drain the abscess faster thus decreasing the stay and requirement of antibiotics. Aim: To study the effectiveness of wide bore PVC catheter (20 Fr) in drainage of large peripheral liver abscess as compared to the use of pigtail catheter (10 Fr). Methods: The study was prospective comparative study done at a tertiary care hospital. Over a period of 22 months, 60 patients of amoebic liver abscess were assigned to undergo pigtail catheter drainage by 10 Fr. Versus wide bore 20 Fr PVC catheter drain and the outcomes were compared. Results: Use of wide bore (20 Fr) PVC catheter significantly decreased the duration of treatment, led to faster drainage of abscess and decreased incidence of recurrence in large amoebic liver abscess, as compared to pigtail catheter drainage by the standard 10 Fr pigtail catheter. Conclusion: 20 Fr PVC catheter is safe and efficacious for evacuating large solitary peripheral liver abscesses and should be preferred to narrow bore pigtail catheter.
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Background: Treatment of the liver abscess of any etiology has evolved in the recent years. Percutaneous drainage of liver abscess has been an important advancement in the treatment of pyogenic liver abscesses. Aim: to evaluate and assess response, morbidity and complication rates of percutaneous pig tail catheter drainage in treatment of liver abscess. Methods: During a period of 27 months, 25 patients with liquefied liver abscess ≥5x5 cm underwent percutaneous drainage under sonographic guidance. Results: 18 had solitary abscess, while 7 had multiple abscesses. Pigtail catheters of various sizes (10 F or 12 F) were introduced in these patients using the Seldinger technique. The volume of pus drained ranged from 150 to 400 ml, while the period of catheter drainage ranged from 6 to 17 days. Complications were minor and included catheter blockage in 2 patients and tract pain in 8 patients. There was no mortality associated with this procedure. This study shows a success rate of 96% (successful treatment in 24 out of 25 patients). Conclusion: Percutaneous catheter drainage of liver abscesses is successful with a low morbidity and mortality and should be the first line of management in liquefied moderate to large sized liver abscesses.
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BACKGROUND: The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. MATERIALS AND METHODS: 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. RESULTS: Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion(9.4+/-5.25 days vs. 19.2+/-9.42 days, p<0.05) and the duration of hospital admission after catheter insertion(15.9+/-10.45 days vs. 38.6+/-11.46 days, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD(11.1+/-7.35 days vs. 19.2+/-9.42 days, p<0.05, 17.5+/-9.17 days vs. 38.6+/-11.46 days, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. CONCLUSION: In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.
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Humans , Male , Anti-Bacterial Agents , Catheters , Chest Tubes , Diagnosis , Drainage , Empyema , Empyema, Pleural , Hemothorax , Horner Syndrome , Lacerations , Medical Records , Pleural Effusion , Pulmonary Edema , Retrospective Studies , Sepsis , Smoke , Smoking , Thoracostomy , Urokinase-Type Plasminogen ActivatorABSTRACT
PURPOSE: Pneumothorax develops frequently as a complication of respiratory diseases and in the course of management in newborn. We compared therapeutic effects and complications of conventional tube thoracotomy and Pigtail catheter inserted by modified Fuhrman's technique for pneumothorax in neonates. METHODS: We reviewed the clinical records of 22 infants with pneumothorax treated with tube thoracotomy and 14 infants with Pigtail catheter, admitted at Kangnarn Sacred Heart Hospital and ChunCheon Sacred Heart Hospital between Jan 1995 and Jul 1998. Sex ratio(13: 9 vs. 7: 7), gestational age(32.7+/-4.3 vs. 31.5+/-5.5 wks), birth weight(1906+/-1025 vs. 1836+/-1128 g) and the incidence of tension pneumothorax(68% vs. 59%) and spontaneous pneumothorax(18% vs. 35%) were not significantly different between two groups. RESULTS: The tube insertion time(5.1+/-4.8 vs. 4.3+/-4.1 days of life), duration of tube insertion(168+/-150 vs. 86+/-78 hrs), duration of mechanical ventilation after tube insertion (8.6+/-6.9 vs. 5.8 and mortality during tube insertion(65% vs. 43%) were not significantly different between tube thoracotomy group and Pigtail catheter inserted group. The complications such as hemothorax and pulmonary hemorrhage were found in 7 cases in tube thoracotomy group but none in Pigtail catheter inserted group. CONCLUSION: Conventional chest tube insertion for pneumothorax can often be traumatic, but Pigtail catheter insertion is safer and easier. Percutaneous placement of Pigtail catheters may be a useful alternative to the conventional method of thoracotomy tube placement in small infants.
Subject(s)
Humans , Infant , Infant, Newborn , Catheters , Chest Tubes , Heart , Hemorrhage , Hemothorax , Incidence , Mortality , Parturition , Pneumothorax , Respiration, Artificial , Thoracostomy , ThoracotomyABSTRACT
BACKGROUND: Lung abscess is an accumulation of pus within a destroyed portion of the lung. Antibiotic therapy and postural drainge has proven to be an effective method of treatment for the majority of patients with pyogenic lung abscess. When medical therapy fails, thoracotomy and pulmonary resection are the current therapies. Empyema is pus in the pleural space, and this term is reserved for effusions on which the Gram stain of the pleural fluid is positive. Initially, such collection may be drained via chest tube. Recently, in patients who are judged to be unsuitable for surgery and are in poor condition, percutaneous drainage using pig-tail catheter has been performed. We report our experience with 10 cases of lung abscess and 23 cases of empyema who were treated by percutaneous pig-tail catheter drainage. SUBJECTS AND METHODS: Our study included 10 patients with lung abscess and 23 patients with empyema who were treated by percutaneous pig-tail catheter drainage, from January, 1990, to May, 1996, at Hanyang University then a pig-tail catheter was inserted into the abscess or the site of empyema under fluoroscopic and ultrasonograpic guidance. Following aspiration, the catheter was sutured into the skin, and connected to the suction tip. Catheter drainage was discontinued when the abscess or empyema was resolved in radiologically and clinically. RESULTS: There were 2 cases of lung abscess caused by Staphylococcus aureus and Klebsiella pneumoniae and 14 cases of empyema caused by M. tuberculosis. The others were unknown. The duration of drainage was 1-2 weeks in 7 cases of lung abscess and 14 cases of empyema. In the 29 of 33 patients, percutaneous drainage were carried out successfully. 20 of the 29 cases rapidly improved. CONCLUSION: Percutaneous drainge is effective and relatively safe for management of lung abscess or empyema refractory to medical therapy or poor candidates for surgical treatment.