The Buzdar Technique for Pulmonary Parenchymal Chest Tube Removal: Prospective Evaluation of a Novel Minimally Invasive Protocol

What this Trial Is About

Chest tube thoracostomy is a critical procedure used to treat conditions like pneumothorax, hemothorax, empyema, and pleural effusions, especially in trauma and thoracic surgery. Despite its frequent use worldwide, complications occur in 20% to 40% of cases, with pulmonary parenchymal chest tube (PPcT) insertion being a rare but serious issue. This procedure is particularly important in Pakistan due to high rates of chest trauma and pneumothorax, yet minimally invasive removal methods for PPcT are lacking. The Buzdar Technique was developed as a novel, minimally invasive, three-stage method to safely remove these tubes without surgery. The Buzdar Technique involves three phases: first, leaving the chest tube in place for about two weeks to allow healing and fibrosis of the lung tissue; second, a gradual initial retraction of 2 cm with optional rotation under imaging and clinical observation, followed by 24 hours of monitoring; and third, weekly staged retractions of 2 cm until the tube is fully removed from the pleural cavity. This approach avoids the need for surgical interventions like thoracotomy or video-assisted thoracic surgery (VATS). Patients receive antibiotic coverage and negative pressure drainage during the process to support healing. Participants in this prospective cohort study will be monitored clinically and with imaging throughout the removal process. Data collected will include demographics, procedural details, complications, lung recovery, and overall outcomes. The primary goal is to achieve complete tube removal without causing pneumothorax, air leak, bleeding, or need for surgery. The study will assess safety, effectiveness, and lung function recovery over the treatment period, with patient follow-up lasting up to two weeks or longer depending on individual progress.

The Buzdar Technique