Tube thoracostomy is the most commonly performed surgical procedure in thoracic surgery. As a life-saving procedure, general surgeons, and respiratory physicians may at one time or the other be required to perform tube thoracostomy.
Chest tubes come in several sizes. Manufacturers use a French catheter scale, abbreviated as Fr, to classify the tubes according to their internal diameter. One Fr is one-third of a millimeter and chest tubes are available in sizes ranging from 6–40 Fr. You can learn more about the thoracic chest tube via centese.com/thoracic-surgery/.
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Doctors can use straight tubes or pigtail tubes, which coil at the end. They will select the size of the chest tube that suits the individual’s anatomy and the procedure.
Chest tubes look like very large, plastic straws. They have three main areas:
- The tip contains drainage holes.
- The body has markings that indicate how far a doctor has inserted the tube.
- The tail, or end, tapers slightly for connection to a suction or drainage system.
Generally, chest tubes divide into two size varieties: large-bore and small-bore. A large-bore chest tube is 20 Fr or larger, while a small-bore chest tube is smaller than 20 Fr.
Smaller tubes are also available and are known as pleural catheters. Doctors will often tunnel them in a vein or carefully place them under the skin of the chest for long-term use.
A pleural catheter may be necessary for a person who has a continual buildup of pleural fluid due to chronic infection, cancer, or liver disease.