Table of ContentsView AllTable of ContentsPurposePlacementRemovalComplicationsPleural Effusions in People With CancerCoping With a Chest Tube
Table of ContentsView All
View All
Table of Contents
Purpose
Placement
Removal
Complications
Pleural Effusions in People With Cancer
Coping With a Chest Tube
A chest tube is a hollow plastic tube that is surgically inserted into the chest cavity to drain air or fluid. Different types of fluid, such as blood, pus, or cancer cells, can accumulate in the chest due to trauma, surgery, cancer, or infection.
Chest tubes are often inserted after lung surgery to remove fluids during healing. They can be inserted during surgery, or with local anesthetic while you are awake. Complications may include pain, bleeding, infection, orpneumothorax(collapsed lung). When an air leak or fluid accumulation persists despite having a chest tube in place, other procedures may be done to prevent the re accumulation of fluid or air into the pleural space.
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A chest tube may be inserted for several reasons:
With less invasive procedures, such as video-assisted thoracoscopic surgery (VATS), a chest tube may not be needed. When a chest tube is used after VATS, it may be removed sooner (for example, often 48 hours) than after a thoracotomy.
When a chest tube is inserted for treating a collapsed lung, a small area on the chest is numbed with a local anesthetic. The tube is then inserted, and connected to a machine that uses suction to remove the air, thus allowing the lung to re-expand. The tube is sutured in place so it won’t pull out of place when you move around.
When a chest tube is inserted immediately after surgery, general anesthesia is used in the operating room. The tube is then connected to a container lower than the chest, using gravity to allow the excess fluids to drain.
How Long Are They Left in Place?
The amount of time a chest tube will remain in place can vary depending on the reason it is placed, and how long an air leak or fluid drainage continues.
For example:
Sometimes a leak persists and other treatment options may be considered. Most air leaks will resolve on their own without further treatment.
Removal of a chest tube is usually a fairly simple procedure than can be done comfortably in your hospital bed without any anesthesia.
The sutures are separated and the tube is then clamped. Your healthcare provider will ask you to take a breath and hold it, and the tube is pulled out. The suture is then tied to close the wound and a dressing applied.
If the tube was placed for a collapsed lung, you may need to have an X-ray to make sure your lung remains expanded after removal.
The complications of chest tube placement may include:
Pleural effusions are very common in people with lung cancer, and commonly occur with metastatic breast cancer as well.
With a pleural effusion, fluid builds up in the pleural space, the area between the two pleural membranes that line the lungs. This space usually contains only the equivalent of three to four teaspoons of fluid. But with lung cancer, several liters of fluid may accumulate, or re-accumulate, quite rapidly.
When cancer cells are present in a pleural effusion, it is termed amalignant pleural effusion. If a malignant pleural effusion is present, it categorizes lung cancer as stage 4.
Recurrent Pleural Effusions
Many people with lung cancer end up having recurrent pleural effusion exerting pressure on the lungs from excess fluid. This causes pain and shortness of breath.
There are many options for treating a recurrent pleural effusion, whether the effusion is benign or malignant.
Shunt Placement
A shunt may also be placed to the outside of your body. This allows people to drain their fluid periodically at home without having to return to the hospital each time fluid accumulates. How often the fluid is drained depends on the symptom severity. The effusion is usually drained for comfort and not because it is medically necessary to remove all of the fluid.
Pleurodesis
Another option for treatment of recurrent pleural effusions ispleurodesis, a procedure that scars down the space between the two pleural membranes.This procedure is done in the operating room with the use of general anesthetic. When the layers of the pleura scar together, it obliterates the pleural space so that there is no longer a cavity available for which fluids to collect.
If you need a chest tube, it’s important that you are attentive to your symptoms. Talk to your doctor about worsening and improvement of symptoms such as shortness of breath and discomfort, and be sure to watch the amount of fluid that you see draining. These symptoms are all indicators that help determine whether the chest tube is helping and how long you need to keep it in.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Collapsed lung (pneumothorax): management and treatment.American Thoracic Society.Patient information series: chest tube thoracostomy.Deng B, Qian K, Zhou JH, Tan QY, Wang RW.Optimization of chest tube management to expedite rehabilitation of lung cancer patients after video-assisted thoracic surgery: a meta-analysis and systematic review.World J Surg. 2017;41(8):2039-2045. doi:10.1007/s00268-017-3975-xAmerican Lung Association.Chest tube procedure.Zamboni MM, da Silva CT Jr, Baretta R, Cunha ET, Cardoso GP.Important prognostic factors for survival in patients with malignant pleural effusion.BMC Pulm Med. 2015;15:29. doi:10.1186/s12890-015-0025-zFortin M, Tremblay A.Pleural controversies: indwelling pleural catheter vs. pleurodesis for malignant pleural effusions.J Thorac Dis. 2015;7(6):1052–1057. doi:10.3978/j.issn.2072-1439.2015.01.51
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Collapsed lung (pneumothorax): management and treatment.American Thoracic Society.Patient information series: chest tube thoracostomy.Deng B, Qian K, Zhou JH, Tan QY, Wang RW.Optimization of chest tube management to expedite rehabilitation of lung cancer patients after video-assisted thoracic surgery: a meta-analysis and systematic review.World J Surg. 2017;41(8):2039-2045. doi:10.1007/s00268-017-3975-xAmerican Lung Association.Chest tube procedure.Zamboni MM, da Silva CT Jr, Baretta R, Cunha ET, Cardoso GP.Important prognostic factors for survival in patients with malignant pleural effusion.BMC Pulm Med. 2015;15:29. doi:10.1186/s12890-015-0025-zFortin M, Tremblay A.Pleural controversies: indwelling pleural catheter vs. pleurodesis for malignant pleural effusions.J Thorac Dis. 2015;7(6):1052–1057. doi:10.3978/j.issn.2072-1439.2015.01.51
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Collapsed lung (pneumothorax): management and treatment.American Thoracic Society.Patient information series: chest tube thoracostomy.Deng B, Qian K, Zhou JH, Tan QY, Wang RW.Optimization of chest tube management to expedite rehabilitation of lung cancer patients after video-assisted thoracic surgery: a meta-analysis and systematic review.World J Surg. 2017;41(8):2039-2045. doi:10.1007/s00268-017-3975-xAmerican Lung Association.Chest tube procedure.Zamboni MM, da Silva CT Jr, Baretta R, Cunha ET, Cardoso GP.Important prognostic factors for survival in patients with malignant pleural effusion.BMC Pulm Med. 2015;15:29. doi:10.1186/s12890-015-0025-zFortin M, Tremblay A.Pleural controversies: indwelling pleural catheter vs. pleurodesis for malignant pleural effusions.J Thorac Dis. 2015;7(6):1052–1057. doi:10.3978/j.issn.2072-1439.2015.01.51
Cleveland Clinic.Collapsed lung (pneumothorax): management and treatment.
American Thoracic Society.Patient information series: chest tube thoracostomy.
Deng B, Qian K, Zhou JH, Tan QY, Wang RW.Optimization of chest tube management to expedite rehabilitation of lung cancer patients after video-assisted thoracic surgery: a meta-analysis and systematic review.World J Surg. 2017;41(8):2039-2045. doi:10.1007/s00268-017-3975-x
American Lung Association.Chest tube procedure.
Zamboni MM, da Silva CT Jr, Baretta R, Cunha ET, Cardoso GP.Important prognostic factors for survival in patients with malignant pleural effusion.BMC Pulm Med. 2015;15:29. doi:10.1186/s12890-015-0025-z
Fortin M, Tremblay A.Pleural controversies: indwelling pleural catheter vs. pleurodesis for malignant pleural effusions.J Thorac Dis. 2015;7(6):1052–1057. doi:10.3978/j.issn.2072-1439.2015.01.51
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