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Assessment of Surgical Outcome of Trocar versus Blunt Dissection Technique for Intercostal Drainage Insertion: A Prospective Interventional Study |
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Ashita Elizabeth Thomas, Anupama K Pujar, VR Anilkumar, Sreekar A Pai 1. Postgraduate Student, Department of Vascular Surgery, M S Ramaiah Medical College, Bengaluru, Karnataka, India. 2. Professor, Department of General Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. 3. Associate Professor, Department of Emergency Medicine, M S Ramaiah Medical College, Bengaluru, Karnataka, India. 4. Associate Professor, Department of General Surgery, M S Ramaiah Medical College, Bengaluru, Karnataka, India. |
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Correspondence Address : Sreekar A Pai, No. 15, 1st Main Road, Industrial Workers Layout, Bengaluru-560096, Karnataka, India. E-mail: sreekarpai76@gmail.com |
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| ABSTRACT |  | ||||||
: Introduction: Chest tube insertion is a common procedure designed to alleviate the accumulation of air, fluid, pus, or blood in the pleural cavity. Despite being a bedside procedure often performed by emergency residents, Intercostal Drain (ICD) tube insertion carries associated risks, if not executed with care. Complications such as misplacement, organ injury, bleeding and pain are noteworthy concerns. Aim: To assess surgical outcome of Trocar versus Blunt dissection technique for ICD insertion. Materials and Methods: The present prospective interventional study was conducted in the Department of General Surgery, M S Ramaiah Hospitals, Bengaluru, India, from September 2018 and August 2020, with a sample size of 64 after obtaining Institutional Ethical Committee approval. Patients requiring ICD insertion were divided into two groups: Blunt (group A) and Trocar (group B) dissection, with 32 participants in each group. Demographic, clinical and diagnostic data were meticulously documented. Statistical analyses, including descriptive statistics, t-tests and Chi-square test, were employed to compare variables such as insertion time, complications and pain scores. Both groups were assessed for the time required for insertion and complications with each method during and after the procedure. Results: The mean age among subjects with the Blunt dissection method and Trocar method was 45.53±14.85 years and 45.06±10.46 years, respectively. In the Blunt dissection technique, 6 (18.8%) were females and 26 (81.3%) were males, while of those who underwent the Trocar method of insertion, 7 (21.9%) were females and 25 (78.1%) were males. The present study findings revealed that the Trocar method demonstrates comparable surgical outcomes to the Blunt dissection method. Trocar insertion proves notably quicker, especially in obese patients. The time taken for insertion was significantly longer (p-value<0.001) with the Blunt dissection method (17.53±8.835 min) compared to the Trocar method (2.31±0.998 min). Significantly more pain was experienced by patients with the Blunt dissection method compared to the Trocar method on day 1 (p-value<0.001). There was no statistically significant difference found between Visual Analog Scale (VAS) score and method of insertion postprocedure. There was a statistically significant difference found between malposition and method of insertion. With the conventional method of insertion, 43.8% of patients had malposition, whereas with the Trocar method of insertion, 18.8% had malposition. Postprocedural complications, including bleeding and infection rates, were comparable between the two methods. Conclusion: In conclusion, the Trocar method exhibits similar surgical outcomes to the Blunt dissection method, with added advantages of reduced insertion time and reduced malposition. Proper training plays a pivotal role in mitigating potential complications, making the Trocar method a clinically viable option for ICD procedures. | |||||||
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| Keywords : Chest tube, Pleural cavity, Thoracostomy, Treatment outcome | |||||||
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DOI and Others :
DOI: 10.7860/IJARS/2024/69935.2989
Date of Submission: Feb 22, 2024 Date of Peer Review: Mar 11, 2024 Date of Acceptance: Apr 06, 2024 Date of Publishing: May 01, 2024 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was Ethics Committee Approval obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. Yes PLAGIARISM CHECKING MET |
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