Thoracentesis techniques: A literature review.

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Procedures

Background:

• Thoracentesis is a common procedure to drain pleural effusions.
• Multiple techniques exist, including gravity, manual aspiration, and various suction methods.
• The safety and complication rates of these different thoracentesis techniques require comprehensive review.

Approach:

• A literature review was conducted, analyzing 6 studies encompassing 20,815 thoracenteses.
• Complication rates were compared across gravity, manual aspiration, vacuum-bottle suction, and wall suction methods.
• Data on procedure duration and specific complication types were extracted and analyzed.

Key Points:

• Overall complication rate was 4.4%, with pneumothorax and re-expansion pulmonary edema (REPE) at 2.5%.
• Manual aspiration had the lowest complication rate (1.2%), while gravity drainage had the highest (47.5%).
• Suction-assisted methods (vacuum and wall) demonstrated shorter procedure times compared to gravity drainage.

Conclusions:

• Thoracentesis by any technique has a low significant complication rate.
• Suction-assisted drainage modalities appear safe and reduce procedure time.
• Operator technique, patient factors, and fluid volume may influence complication rates more than the drainage method itself.