A Novel Technique to Remove Iatrogenic Pulmonary Parenchymal Chest Tube (PPcT): A Retrospective Analysis From a Tertiary Care Thoracic Surgery Centre

NCT07148661 | Completed DMC

• 1 other identifier: IRB/2025/1654/SIMS
• Study Type: observational
• Target: 163
• Locations: 1 country
• Sites: 1

Brief Summary

Iatrogenic Pulmonary Parenchymal chest Tube (PPcT) placement is a recognized but underreported complication of tube thoracostomy, described both in the subcontinent and worldwide. This complication occurs when the chest tube inadvertently traverses the pleural cavity and penetrates the lung parenchyma. Patients with underlying lung pathology are at increased risk of having iatrogenic pulmonary parenchymal chest tube. In this study we describe the safe and minimally invasive technique to remove the PPcT without the need of video assisted thoracic surgery (VATS) or thoracotomy.

Conditions

Iatrogenic Injury; Iatrogenic Disease

Keywords

Pulmonary Parenchymal chest Tube PPcT; Lung Parenchymal Injury; hemodynamic Instability; Removal of Chest Tube; Video Assisted Thoracoscopic Surgery (VATS); Thoracotomy

Outcome Measures

Primary Outcomes (1)

• Hemodynamic Instability

  Hemodynamic Instability after staged removal of chest tube is defined as pulse rate of greater than 120/min, systolic Blood pressure of less than 80 mm of Hg, respiratory rate of greater than 24/min, hemorrhage and persistent air leak in the chest tube. Participants were observed for these above mentioned changes after every staged retraction of chest tube and responses recorded. For the participants who develop hemodynamic instability, thoracotomy was performed and underlying cause for hemodynamic instability is addressed.

  24 hours

Study Arms (1)

PPcT Group

Participants that have been diagnosed with Iatrogenic injury to lung in case of Pulmonary Parenchymal chest tube (PPcT)

Procedure: Removal of PPcT

Interventions

Removal of PPcT PROCEDURE

Iatrogenic Pulmonary Parenchymal Chest Tube is removed as a staged procedure in which gradual retraction of 2cm of chest tube is done from lung parenchyma keeping an eye on the hemodynamic status of Patient.

PPcT Group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients diagnosed with PPcT after chest tube thoracostomy either admitted to the thoracic surgery ward, emergency department, outpatient department and referred to Thoracic surgery department during the study period will be included.

You may qualify if:

• All Participants having PPcT diagnosed on radiological basis is included in this study.

You may not qualify if:

• Participnts having normally placed pleural chest tubes. Participants having chest tubes placed in fissures of the lung diagnosed on CT Scan of chest.

Sponsors & Collaborators

• University of Health Sciences Lahore: lead

Study Sites (1)

Services Institute of Medical Sciences(SIMS), Services Hospital.

Lahore, Punjab Province, Pakistan

Location

MeSH Terms

Conditions

Iatrogenic Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Muhammad Shoaib Nabi, Clinical Professor

  Services Institute of Medical Sciences (SIMS), Services Hospital, Lahore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 23, 2025
• First Posted: August 29, 2025
• Study Start: May 1, 2024
• Primary Completion: April 30, 2025
• Study Completion: July 31, 2025
• Last Updated: August 29, 2025

Record last verified: 2025-08

Locations

PA (1)