Technical validation of pulmonary drainage for the treatment of severe pulmonary emphysema: a cadaver-based study

A cadaver-based study was carried out in order to describe the pulmonary drainage surgical technique, to determine whether the site for the insertion of the chest tube is appropriate and safe, and to determine the anatomical relationship of the chest tube with the chest wall, lungs, large blood vess...

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Bibliographic Details
Published in:Jornal brasileiro de pneumologia 2013-01, Vol.39 (1), p.16-22
Main Authors: Lopez, Júlio Mott Ancona, Saad, Jr, Roberto, Dorgan Neto, Vicente, Botter, Marcio, Gonçalves, Roberto, Rivaben, Jorge Henrique
Format: Article
Language:eng ; por
Subjects:
Adult
Aged
Aged, 80 and over
Anthropometry
Cadaver
Chest Tubes - adverse effects
Drainage - instrumentation
Drainage - methods
Female
Humans
Male
Middle Aged
Original
Pulmonary Emphysema - surgery
Thorax - anatomy & histology
Young Adult
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Summary:A cadaver-based study was carried out in order to describe the pulmonary drainage surgical technique, to determine whether the site for the insertion of the chest tube is appropriate and safe, and to determine the anatomical relationship of the chest tube with the chest wall, lungs, large blood vessels, and mediastinum. Between May and November of 2011, 30 cadavers of both genders were dissected. The cadavers were provided by the Santa Casa de São Paulo Central Hospital Mortuary, located in the city of São Paulo, Brazil. A 7.5-cm, 24 F steel chest tube was inserted into the second intercostal space along the midclavicular line bilaterally, and we measured the distances from the tube to the main bronchi, upper lobe bronchi, subclavian vessels, pulmonary arteries, pulmonary arteries in the upper lobe, superior pulmonary vein, azygos vein, and aorta. Weight, height, and chest wall thickness, as well as laterolateral and posteroanterior diameters of the chest, were measured for each cadaver. Of the 30 cadavers dissected, 20 and 10 were male and female, respectively. The mean distance between the distal end of the tube and the main bronchi (right and left) was 7.2 cm (for both). The placement of a fixed-size chest tube in the specified position is feasible and safe, regardless of the anthropometric characteristics of the patients.
ISSN:1806-3713
1806-3756
DOI:10.1590/S1806-37132013000100003