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Updated: Sep 30, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
An evidence-based approach to drainage of the pleural cavity: evaluation of best practice
Augustine T M Tang1, Theodore J Velissaris, David F Weeden
1Department of Thoracic Surgery, Wessex Regional Cardiac and Thoracic Unit, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK. gus.tang@ntlworld.com
Abstract:
Recent surveys have uncovered major variations in key aspects of intercostal drain management, suggesting that decisions are being made on individual preferences without resorting to sound evidence. We provide an up-to-date review of the best practice with evidence-based recommendations and expert consensus views. The following aspects of chest drain management have been addressed: indications for drainage, insertion technique, complications, management of an indwelling chest drain, indications and technique for removal. The emphasis in this review is that safe intercostal drain practice relies upon adherence to a few important principles. Furthermore, when in doubt, particularly with a complex thoracic problem, one should seek prompt specialist advice.
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