Acute medicine & surgery · 2026
Impact of Preceding Chest CT on Functional Malpositioning of Chest Tubes in Traumatic Pneumothorax and Hemopneumothorax.
СтатьяНазвание и аннотация: Перевод в очереди
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Mitani Yuki, Nishikimi Mitsuaki, Ishii Junki, Kyo Michihito, Yamaga Satoshi, Ohshimo Shinichiro, Shime Nobuaki
Аннотация
BACKGROUND: It remains controversial whether the lateral or the anterior approach is optimal for chest tube insertion in patients with traumatic pneumothorax (PTH).
OBJECTIVES: This study aimed to evaluate the incidence of functional malpositioning of chest tubes inserted via the lateral versus anterior approach in patients with traumatic pneumothorax (PTH) and/or hemopneumothorax (HPTH), with or without a preceding CT examination.
METHODS: We conducted a two-center, retrospective, observational study of consecutive patients treated with a chest tube for traumatic PTH/HPTH between August 2012 and September 2021. Patients were divided into two groups according to the presence or absence of CT examination before chest tube insertion: CT(+) or CT(-) group. In each group, the risk of functional malpositioning was compared between the lateral and anterior approaches.
RESULTS: Among 388 patients, 271 patients were analyzed. The CT(+) group comprised 200 (74%) patients, while the CT(-) group comprised 71 (26%) patients. The adjusted odds ratio of functional malpositioning with the lateral approach was 1.38 (95% confidence interval 0.64-2.98, p = 0.41) in the CT(+) group and 9.24 (95% confidence interval 1.49-57.50, p < 0.01) in the CT(-) group. There was a trend suggesting that the risk of functional malposition of chest tubes associated with the lateral approach, compared with the anterior approach, was modified by the presence or absence of a preceding CT examination (p interaction = 0.01).
CONCLUSIONS: The occurrence of functional malpositioning of the chest tube in patients with traumatic PTH/HPTH was higher with the lateral approach in patients without a preceding CT examination.
OBJECTIVES: This study aimed to evaluate the incidence of functional malpositioning of chest tubes inserted via the lateral versus anterior approach in patients with traumatic pneumothorax (PTH) and/or hemopneumothorax (HPTH), with or without a preceding CT examination.
METHODS: We conducted a two-center, retrospective, observational study of consecutive patients treated with a chest tube for traumatic PTH/HPTH between August 2012 and September 2021. Patients were divided into two groups according to the presence or absence of CT examination before chest tube insertion: CT(+) or CT(-) group. In each group, the risk of functional malpositioning was compared between the lateral and anterior approaches.
RESULTS: Among 388 patients, 271 patients were analyzed. The CT(+) group comprised 200 (74%) patients, while the CT(-) group comprised 71 (26%) patients. The adjusted odds ratio of functional malpositioning with the lateral approach was 1.38 (95% confidence interval 0.64-2.98, p = 0.41) in the CT(+) group and 9.24 (95% confidence interval 1.49-57.50, p < 0.01) in the CT(-) group. There was a trend suggesting that the risk of functional malposition of chest tubes associated with the lateral approach, compared with the anterior approach, was modified by the presence or absence of a preceding CT examination (p interaction = 0.01).
CONCLUSIONS: The occurrence of functional malpositioning of the chest tube in patients with traumatic PTH/HPTH was higher with the lateral approach in patients without a preceding CT examination.