الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Drainage and decompression of the pericardial and/or pleural spaces is necessary following open heart surgery. The pleural space may be opened intentionally during CABG operation to prepare the internal mammary artery or accidently during other open heart surgeries.
The primary goals are removal of blood to prevent cardiac tamponade (short-term) or constrictive pericarditis (long-term), to prevent development of clinically significant pleural effusions or pneumothorax and to monitor bleeding.
The aim of the study was to compare between subxiphoid and intercostal approach for chest tube insertion as regard postoperative pain and pulmonary morbidities after open heart surgery in adults.
This study included 40 patients (n=40) presenting to cardiothoracic surgery department in Alexandria University Hospitals to undergo open heart surgery with pleurotomy (either accidental or during mammary artery harvesting) from May till September 2014.
This study included 40 patients divided into 2 groups. group I (the subxiphoid group) included 20 patients. group II (the intercostal group) included 20 patients.
The study included 11 males and 9 females in group I, while in group II 10 males and 10 females. The age of patients in group I ranged from 25 to 68 years, while in group II varied from 25 to 76 years.
In 15 patients (75%) in group I unilateral drains were inserted while in 5 patients (25%) bilateral tubes. 13 patients in group II (65%) had unilateral drains and only 7 patients (35%) had bilateral tubes.
3 patients in group I (15%) required postoperatively drainage of residual or newly accumulating pleural effusion (either through intercostal tube insertion or U/S guided aspiration), while only 2 patients (10%) in group II required postoperative drainage of pleural effusion. The difference was not statistically significant.