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

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Published Jan 11, 2024
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Vol. 101 No. 12 (2023): Tunis Med dec 2023

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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

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.

Keywords:

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

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