Drainage of tuberculous pneumothorax in a Northern African country: Characteristics and difficulties

Authors

  • Soumaya Ben Saad Department of Respiratory C. Abderahmen Mami Hospital, Ariana, Tunisie, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisie
  • Samia Sbaa Department of Respiratory C. Abderahmen Mami Hospital, Ariana, Tunisie, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisie
  • Amani Ben Mansour Department of Respiratory C. Abderahmen Mami Hospital, Ariana, Tunisie, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisie
  • Azza Slim Department of Respiratory C. Abderahmen Mami Hospital, Ariana, Tunisie, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisie
  • Hedia Bellali Department of epidemiology. Habib Thameur Hospital, Tunis, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisie
  • Henda Neji Department of radiology. Abderahmen Mami Hospital, Ariana, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
  • Sarra Zairi Department of thoracic surgery. Abderahmen Mami Hospital, Ariana, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
  • Hafaoua Daghfous Department of Respiratory C. Abderahmen Mami Hospital, Ariana, Tunisie, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisie
  • Fatma Tritar Department of Respiratory C. Abderahmen Mami Hospital, Ariana, Tunisie, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisie

Keywords:

Drainage, Mycobacterium Tuberculosis, North Africa, Pleural Effusion, Prognosis, Tunisia

Abstract

Introduction-Aim: Tuberculous pneumothorax (TP) is a serious complication of cavitary pulmonary tuberculosis. The aim of this study was to identify TP drainage characteristics and difficulties.

Methods: This was a retrospective multicenter study of patients hospitalized for TP between 1999 and 2021 in three hospitals from Tunis (Tunisia): Abderahmen Mami, La Rabta, and Charles Nicolle. Clinical, biological, radiological, therapeutic and evolutionary data were collected.

Results: Seventy-three patients were enrolled. The mean±standard-deviation (SD) of age was 37±17 years. The sex ratio was 3.3. TP was isolated in 39 patients (53.4%) and was associated with a purulent effusion in 34 patients (46.6%). It was bilateral in three patients (4.1%). Chest drainage was indicated in 67 patients (91.7%). It was performed with a chest drain in 61 cases, with a pleuro-catheter in one case, and with a pleuro-catheter then a chest drain in five cases. The mean±SD (ranges) duration of drainage was 43±39 (3-175) days. Drainage was prolonged in 36 cases (53.7%). The duration of drainage for pyopneumothorax was significantly longer than for isolated TP (p=0.04). The mean±SD (ranges) number of drains inserted in each patient was 2.02 ±1 (1-7) drains. Spontaneous drain fall was observed in 13 patients. Drainage failure was observed in 16 patients, and was more frequent in cases of pyopneumothorax (p=0.039). Recurrence of pneumothorax was noted in nine patients (13.4%).

Conclusion: The drainage of TP is often extended and requires the use of multiple drains. It is associated with several complications. Failure of thoracic drainage is not negligible.

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2024-01-11

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Vol. 101 No. 12 (2023): Tunis Med dec 2023

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