Chest Tube Drainage Research Articles

Evaluation of the short-term efficacy of fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins in sublobar resection for early-stage non-small cell lung cancer

Objective: To investigate the effectiveness and safety of fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins during sublobar resection for the treatment of early-stage non-small cell lung cancer (NSCLC). Methods: This is a prospective cohort study. Patients with early-stage NSCLC who underwent fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins for sublobar resection in the Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, from January to April 2024 were included. Based on whether the artery or vein was blocked during surgery, the patients were divided into the arterial group and the venous group. The surgical time, intraoperative blood loss, distance from the lesion to the resection margin, and boundary duration were collected and compared between the two groups. Independent sample t test, Mann-Whitney U test, or χ2 test was used to compare the data between the two groups. Results: A total of 64 patients were enrolled. There were 25 males and 39 females, aged (57.3±12.1) years (range: 34 to 80 years). The tumor diameter was (9.8±2.9) mm (range: 5 to 16 mm), The distance between the surgical margin and the lesion was (16.5±3.9) mm (range: 10 to 30 mm) and the surgical time was (61.5±13.9) minutes (range: 30 to 120 minutes). Pathological examination of the surgical specimens showed that all margins met pathological requirements. The chest drainage tube retention time (M(IQR)) was 2 (1) days (range: 1 to 7 days), and no serious postoperative complications occurred. The boundary duration for the arterial group (n=23) and venous group (n=41) was (147.9±22.2) seconds (range: 119 to 188 seconds) and (40.9±8.0) seconds (range: 20 to 60 seconds), respectively (t=27.935, P<0.01). Conclusion: Fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins can effectively and accurately delineate surgical resection boundaries, ensuring sufficient margin width to meet oncological requirements.

Outcomes of internal rib fixation through complete video-assisted thoracoscopic surgery for multiple rib fractures and flail chest in severe chest trauma

BackgroundSurgical stabilization of rib fractures (SSRF) is a standard treatment for multiple rib fractures and flail chest. The aim of this study is to evaluate the outcomes of internal rib fixation through complete video-assisted thoracoscopic surgery (VATS) for multiple rib fractures and flail chest in patients with severe chest trauma.MethodsThirty-nine patients with multiple rib fractures caused by severe chest trauma were divided into two groups according to the surgical approach used. Twenty-one patients were diagnosed with flail chest. In the thoracoscopic surgery group, 17 patients underwent internal rib fixation through complete VATS. In the open surgery group, 22 patients underwent surgery with open reduction and internal fixation. Surgical variables, such as operation time, intraoperative blood loss, chest tube drainage volume, complications, visual analog scale (VAS) of pain score, postoperative ventilator days, Intensive Care Unit (ICU) stay and hospital stay, were compared between the two groups.ResultsThere were no differences in operation time, intraoperative blood loss, chest tube drainage volume, postoperative ventilator days, ICU stay or hospital stay between the two groups (P > 0.05). Although there was no significant difference in overall postoperative complications (P = 0.358), the incidence of postoperative pleural effusion was lower in the thoracoscopic surgery group than in the open surgery group (P = 0.025). The VAS score in the thoracoscopic surgery group was also significantly lower than that in the open surgery group on the seventh day after surgery (P = 0.014).ConclusionsInternal rib fixation through complete VATS is a feasible and safe approach for treating multiple rib fractures and flail chest in patients with severe chest trauma.

Congenital Diaphragmatic Hernia Presenting as Tension Hydropneumothorax: Surgical Dilemma

Introduction: Congenital diaphragmatic hernia (CDH)most commonly seen on the left side, presenting usually in neonates and infants with respiratory distress. Importance: CDH presenting as tension hydropneumothorax requiring urgent intercostal chest tube drainage (ICD) and subsequently inducing the injury to the herniated bowel and lung, is not an uncommon event, rarely reported in toddlers as well as its management Case presentation: Two such rare cases of CDH presenting with tension hydropneumothorax requiring ICD insertion and their consequences have been discussed here. Clinical discussion: CDH can present later in life due to consequent recurrent bronchopneumonia and failure to thrive. Conclusion: Clinical history and clinical judgement can only aid the surgeon in avoiding the confusion.

Success of Expectant Observation and Needle Aspiration in Reducing the Need for Chest Tube Drainage for Management of Neonatal Pneumothoraces

Success of Expectant Observation and Needle Aspiration in Reducing the Need for Chest Tube Drainage for Management of Neonatal Pneumothoraces

Apixaban removal during emergency surgery for type A acute aortic dissection: a prospective cohort study.

Acute type A aortic dissection (ATAAD) has a high mortality, and acute aortic repair is the only curative treatment. In patients treated with factor Xa (FXa) inhibitors, the risk of severe disease-related complications such as cardiac tamponade and hemodynamic shock must be balanced against the potential for severe perioperative bleeding. The aim was to study intraoperative changes in plasma levels of the FXa inhibitor apixaban when using hemoadsorption during acute thoracic aortic repair. This is a single-center prospective cohort study. Eight apixaban-treated patients presenting with ATAAD underwent acute thoracic aortic repair with intraoperative hemoadsorption with CytoSorb. Apixaban concentrations were measured at the start of cardiopulmonary bypass (CPB) and after 5, 15, 30, 60, and 90min of CPB, at CPB weaning, 30min after CPB weaning and 24h postoperatively, using ultraperformance liquid chromatography-mass spectrometry (UPLC-MS). After 30min of CPB with hemoadsorption, mean apixaban concentration (±SD) was reduced by 59% from 108 (±69)µg/l to 44 (±20)µg/l (P=0.009). There was a further reduction to 37 (±17)µg/l at CPB weaning (P=0.008). Apixaban concentration displayed an increase to 56 (±29)µg/l 24h postoperatively (P=0.01). In-hospital mortality was 25%. The mean 24H chest tube drainage volume was 621 (±136)ml. Intraoperative hemoadsorption lowers apixaban levels in patients undergoing emergency surgery for ATAAD. Further research is needed to determine its impact on perioperative bleeding complications and mortality.

4-Factor prothrombin complex concentrates and factor VIII inhibitor bypass activity use in cardiac surgery.

The objective of this study was to compare total thromboembolic complications between 4-factor prothrombin complex concentrate (4F-PCC) with factor VIII inhibitor bypassing activity (FEIBA) when utilized during cardiac surgery. A quasi-experimental analysis of retrospective data from consecutive patients. A tertiary care university hospital. Patients undergoing cardiac surgery with cardiopulmonary bypass. Patients received either 4F-PCC or FEIBA after discontinuation of cardiopulmonary bypass and reversal of heparin with protamine. Medical records were reviewed for thromboembolic events (stroke, arterial or venous thrombosis, pulmonary embolism, myocardial infarction), acute kidney injury, ischemic bowel, death, duration of intensive care unit and hospital stay, clinical and surgical characteristics and blood product utilization. A comparison of the clinical and surgical variables demonstrated a mean effect size of 0.33 imbalance between groups that was reduced to 0.18 after propensity score weighting. The propensity scores weighted analysis found an incidence of composite thromboembolic events of 39% in the 4F-PCC (n = 90) and 47% in the FEIBA (n = 50) group, difference -8 (-24% to 12%), P = 0.13. Individual thromboembolic events, acute kidney injury, ischemic bowel, mortality, and length of intensive care unit or hospital stay was not different among groups. Patients who received FEIBA had greater chest tube drainage and received more cryoprecipitate intraoperatively. Patients who received 4F-PCC received more fresh frozen plasma transfusions postoperatively. Among cardiac surgery patients, there was no difference in thromboembolic events between patients who received 4F-PCC or FEIBA when used as an adjunct to blood product administration.

The Analysis Study of Comparison of Chest Tube Drainage vs Conservative Management of Pneumothorax: A Comprehensive Systematic Review

Background: The management of pneumothorax significantly across different clinical guidelines, reflecting ongoing uncertainty in the optimal approach to treatment. Recent research has highlighted the potential benefits of conservative management compared to surgical approach. This systematic review aims to compare the outcomes of conservative management and chest tube drainage in the treatment of pneumothorax by analyzing available studies of the last 10 years. Methods: The study adhered to PRISMA 2020 standards, examining English literature from 2014 to 2024. It excluded editorials, reviews from the same journal, and submissions without a DOI. PubMed, SagePub, SpringerLink, and Google Scholar were utilized as literature sources. Result: Initially retrieving 360 articles from online databases (PubMed, SagePub, SpringerLink and Google Scholar) eight relevant papers were selected after three rounds of screening for full-text analysis. Conclusion: Conservative management of pneumothorax, particularly in clinically stable patients, has shown effectiveness comparable to chest tube drainage, with benefits such as shorter hospital stays and fewer complications. However, careful patient selection and further trials are needed to confirm its long-term safety and efficacy.

Respiratory endoscopy intervention in 12 patients with refractory persistent air leakage after pulmonary surgery: a preliminary study of case series

ObjectiveTo explore the value of our protocol of respiratory endoscopy intervention in the treatment of refractory persistent air leakage(PAL) after pulmonary surgery.MethodA retrospective study was conducted in 12 patients with PAL after pulmonary surgery who were successfully treated by our protocol of respiratory endoscopy intervention in the Department of Respiratory and Critical Care Medicine of the Fourth Hospital Affiliated to Soochow University and the First Hospital Affiliated to Soochow University from December 2019 to January 2024. 4 types of treatment were included in our protocol; A: chest tube drainage combined with negative pressure suction; B: medical thoracoscopy with chest tube as a path; C: stimulating bronchial mucosa hyperplasia under bronchoscopy; D: blocking of the fistula orifice with the relevant materials under the bronchoscope; And the specific treatment received by each patient was based on the condition of the patient.ResultsThe bronchopleural fistula was found in 7 patients; The fistula orifice was found in 5 patients and the diameter of fistula orifices were 4.0–12.0 mm, with an average of 7.2 ± 3.6 mm. Among the 7 patients with bronchopleural fistula, 1 patient received C + D, 1 patient received A + B + C, 1 patient received A + C + D, 4 patients received A + B + C + D; Among the 5 patients with fistula orifice, 2 patients received C + D, 2 patients received A + B + D, 1 patient received A + C + D. All the 12 patients were effectively treated, among which 9 patients who underwent chest tube drainage were successfully extubed. The median (interquartile distance) retention time of chest tubes before and after our protocol of respiratory endoscopy intervention were respectively 73.5(50.5,106.25) days and 29(22,38.75) days, p < 0.05.ConclusionsOur protocol of respiratory endoscopy intervention can significantly shorten the retention time of the patient’s chest tube and effectively treat refractory PAL after pulmonary surgery. However, it should be emphasized that individualized therapy should be provided according to the location and size of the fistula orifice.

Atomized inhalation of indocyanine green in thoracoscopic surgery for intralobar pulmonary sequestration: a multicenter study

BackgroundInvestigate the safety and efficacy of preoperative atomization inhalation of indocyanine green (ICG) solution in precise lesion resection of pediatric thoracoscopic intralobar pulmonary sequestration.MethodsA multicenter 1:1 matched case-control study was adopted, to compare the safety and efficacy of the ICG group (preoperative atomization inhalation of 0.5 mg/kg ICG solution) with traditional group (no preoperative atomization inhalation of ICG solution). The baseline, intraoperative, and postoperative recovery conditions of the two groups were observed. Outpatient follow-up visits were conducted 3 to 6 months after surgery, including lung CT scans and pulmonary ventilation function tests.Results134 patients were included in the study. The ICG group included 67 patients, and the traditional surgery group included 67 patients matched at a ratio of 1:1 according to age and lesion location. There were no reports of deaths or adverse reactions. The postoperative chest drainage tube indwelling time [(53.19 ± 8.15) hours vs. (73.25 ± 15.51) hours, P < 0.001] and postoperative hospital stay [(4.81 ± 1.84) days vs. (6.72 ± 1.31) days, P < 0.001] were shorter in the ICG group than in the traditional group. More importantly, the postoperative pulmonary function in the ICG group was better than that in the traditional group. No residual lesions were found in the postoperative CT examination of both groups.ConclusionsThe innovative application of atomization inhalation of ICG provides the possibility for precise localization and lesion resection of pediatric thoracoscopic intralobar pulmonary sequestration. This maximizes the preservation of normal lung parenchyma, better improves postoperative pulmonary function, and shortens postoperative recovery time.

Bilateral chylothorax following papillary thyroid carcinoma with cervical lymph node dissection: Case report and comprehensive review of the literature.

This case analysis and literature review aim to identify the causes of bilateral chylothorax following thyroid cancer surgery, a rare yet serious complication. We report 2 East Asian women who developed bilateral chylothorax after undergoing total thyroidectomy with neck lymph node dissection. Both patients presented with dyspnea and significant pleural effusion postoperatively. Both patients were diagnosed with bilateral chylothorax based on clinical examination and imaging studies, including chest ultrasonography and X-rays. In both cases, conservative management was initially implemented, involving chest tube drainage, total parenteral nutrition, and octreotide therapy. Surgical intervention was considered if conservative measures failed to control the chylous output. Both patients showed gradual improvement with conservative treatment, ultimately resulting in successful resolution of pleural effusion and discharge from the hospital without complications. For patients with bilateral chylothorax, conservative treatment should be the initial approach for small effusions. For moderate to large effusions, placement of a chest drainage tube is recommended, and surgical intervention should be considered if chyle volume exceeds 10 mL/(kg/d) for 48 to 72 hours or persists for more than 11 days following conservative treatment.

Proper duration of antibiotics after video-assisted thoracoscopic surgery for the treatment of thoracic empyema

Background When chest tube drainage does not adequately resolve thoracic empyema, video assisted thoracoscopic surgery (VATS) is often needed. However, the proper duration of antibiotics after VATS is poorly defined. Consequently, the objective of this study was to evaluate if short antibiotic durations post-VATS was equally effective compared to longer durations. Methods Patients with thoracic empyema treated with VATS were identified retrospectively by a query of the hospital billing database. The bacterial causes of the empyema were divided into 8 different categories while the antibiotic duration after VATS was divided into two groups which included antibiotics ˂ 14 days and antibiotics >14 days. The primary outcome measured was rates of empyema recurrence. Statistical comparisons were conducted between the antibiotic duration groups overall and when stratified based on the different bacterial causes. Results 137 patients were included in this study with the main cause of empyema being culture negative empyema (37.2%) while alpha haemolytic Streptococcus spp. was the most cultured bacteria (26.3%). There was no statistical difference (p = 0.5168), in the rates of empyema recurrence, when short antibiotic durations (median 11.6 days)were compared to longer antibiotic durations (median 29.1 days)post-VATS. Nor was there a statistical difference in recurrence rates when stratifying based on bacterial cause. Conclusion This study reinforces that antibiotic durations less than 14 days post-VATS are equally effective as prolonged antibiotic durations. However, to determine the proper duration of antibiotic therapy post-VATS, a prospective clinical trial is needed to reduce complications of prolonged antibiotic therapies for these patients.

Subcutaneous emphysema in patients undergoing robotic cardiac surgery: risk factors and clinical outcome.

Little is known about the incidence of subcutaneous emphysema (SE) after robotic cardiac surgery. The aim of this study was to describe the incidence, identify risk factors, and assess its influence on postoperative outcomes. Patients undergoing robotic mitral valve repair (n = 63, 54.3%), robotic minimally invasive direct coronary artery bypass grafting (n = 23, 19.8%), and robotic totally endoscopic coronary artery bypass grafting (n = 30,25.9%) were included in the analysis (total n = 116). Subcutaneous emphysema occurred in 53/116 patients (45.7%). It was mild in 30/53 patients (56.6%), moderate in one patient (1.9%), and severe in 22/53 patients (41.5%). Low body weight (p = 0.009), low BMI (p = 0.006), small body surface area (p = 0.01), and older age (p = 0.041) significantly correlated with SE. Patients undergoing robotic mitral valve repair were affected more often than patients undergoing robotic coronary artery bypass grafting (p = 0.04). Severe subcutaneous emphysema resulted in an increased need for CT-chest imaging (p = 0.026), and additional chest tubes (p = 0.029). Severe emphysema was highly associated with pneumothorax (p < 0.001) and increased duration of chest tube drainage (p = 0.003). Subcutaneous emphysema after robotic heart surgery occurs preferentially in patients with low body weight, low BMI, a small body surface area, and older age and is more common in robotic MVR than in robotic coronary artery bypass surgery. It leads to an increased need for thoracic imaging and additional chest tube insertion. Clinical outcomes are not affected.

Bilateral multiple ribs and sternum fracture causing central flail chest with respiratory failure

Bilateral thoracic blunt injuries in a patient may present with central Flail chest, and acute respiratory failure which is one of the life-threatening complications. We present a case of central flail chest caused by blunt trauma, successfully managed with operative rib and sternum fixation. A 35-year male with a central flail chest with acute respiratory failure caused by road-traffic accident who was managed initially with bilateral intercostal chest-tube drainage for significant bilateral hemopneumothorax and lung contusions. The patient was intubated and connected to mechanical ventilatory support with positive pressure ventilation for the internal pneumatic stabilization. There were multiple rib fractures anteriorly (first to seventh rib bilaterally) and fracture of the sternum - the flail chest, for which he underwent bilateral rib fixation and fixation of sternum with titanium reconstruction plate and screws on the 9th postinjury day. Tracheostomy was done along with fixation in the same sitting. Post-operatively, after 48 hours of positive pressure mechanical ventilation, the weaning was started and by the 4-5th day, the patient was on room air with a tracheostomy tube. The patient recovered uneventfully and was discharged on the eighth postoperative day.

Chest Tubes and Pleural Drainage: History and Current Status in Pleural Disease Management.

Thoracostomy and chest tube placement are key procedures in treating pleural diseases involving the accumulation of fluids (e.g., malignant effusions, serous fluid, pus, or blood) or air (pneumothorax) in the pleural cavity. Initially described by Hippocrates and refined through the centuries, chest drainage achieved a historical milestone in the 19th century with the creation of closed drainage systems to prevent the entry of air into the pleural space and reduce infection risk. The introduction of plastic materials and the Heimlich valve further revolutionized chest tube design and function. Technological advancements led to the availability of various chest tube designs (straight, angled, and pig-tail) and drainage systems, including PVC and silicone tubes with radiopaque stripes for better radiological visualization. Modern chest drainage units can incorporate smart digital systems that monitor and graphically report pleural pressure and evacuated fluid/air, improving patient outcomes. Suction application via wall systems or portable digital devices enhances drainage efficacy, although careful regulation is needed to avoid complications such as re-expansion pulmonary edema or prolonged air leak. To prevent recurrent effusion, particularly due to malignancy, pleurodesis agents can be applied through the chest tube. In cases of non-expandable lung, maintaining a long-term chest drain may be the most appropriate approach and procedures such as the placement of an indwelling pleural catheter can significantly improve quality of life. Continued innovations and rigorous training ensure that chest tube insertion remains a cornerstone of effective pleural disease management. This review provides a comprehensive overview of the historical evolution and modern advancements in pleural drainage. By addressing both current technologies and procedural outcomes, it serves as a valuable resource for healthcare professionals aiming to optimize pleural disease management and patient care.

Early diaphragm dysfunction assessed by ultrasonography after cardiac surgery: a retrospective cohort study.

Approximately 10%-70% of patients may develop diaphragmatic dysfunction after cardiac surgery, which may lead to delayed weaning from mechanical ventilation, increased ICU stays, postoperative hospitalization stays, and respiratory complications. However, its impact on prognosis and risk factors remain controversy. Therefore, we conducted a retrospective cohort study in which we evaluated diaphragmatic dysfunction in patients who underwent cardiac surgery via bedside diaphragm ultrasound to investigate its prognosis and possible risk factors. Data from the electronic medical records system included case records and ultrasound images of the diaphragm for 177 consecutive patients admitted to the ICU following cardiac thoracotomy surgeries performed between June and September 2020. Diaphragmatic dysfunction was defined as a diaphragmatic excursion of less than 9 mm in women and less than 10 mm in men at rest, with an average thickening fraction of less than 20%. SPSS 25.0 software was used to analyse the relationships between patients' general information, intraoperative and postoperative factors and diaphragmatic dysfunction, as well as the impact on patients' hospitalization days, mechanical ventilation time and respiratory system complications. The incidence of early postoperative diaphragmatic dysfunction after cardiac surgery was 40.7%. Patients with diaphragmatic insufficiency were more likely to sequentially use noninvasive ventilation within 24 h after weaning off mechanical ventilation (3.8% vs. 12.5%, P = 0.029) and to require more oxygen support (23.8% vs. 40.3%, P = 0.019). Although there was no significant difference, the diaphragmatic dysfunction group tended to have longer ICU stays and postoperative hospital stays than did the normal diaphragmatic function group (P = 0.119, P = 0.073). Univariate and multivariate logistic regression analyses both revealed that chest tube drainage placed during surgery accompanied by bloody drainage fluid was an independent risk factor for diaphragmatic dysfunction (univariate analysis: 95% CI: 1.126-4.137, P = 0.021; multivariate analysis: 95% CI: 1.036-3.897, P = 0.039). Eearly diaphragmatic dysfunction after cardiac surgery increased the proportion of patients who underwent sequential noninvasive ventilation after weaning from mechanical ventilation and who required more oxygen. Chest tube drainage placed during surgery accompanied by bloody drainage fluid was an independent risk factor for diaphragmatic dysfunction, providing evidence-based guidance for respiratory rehabilitation after cardiac surgery.

EP.07A.14 The Postoperative Chest Tube Drainage Strategy of "Lesstube" Can Reduce Patient Pain and Shorten Hospital Stay

EP.07A.14 The Postoperative Chest Tube Drainage Strategy of "Lesstube" Can Reduce Patient Pain and Shorten Hospital Stay

Challenges of Diagnosis and Management of Congenital Chylothorax in a Low-Resource Setting: A Case Report

Chylothorax is a form of pleural effusion. In the neonate, it may be diagnosed in the antenatal or postnatal period. Congenital forms of chylothorax are due to abnormal development or obstruction of the lymphatic system and may be associated with hydrops foetalis; it may also be idiopathic or associated with chromosomal anomalies. The diagnosis is usually based on biochemical analysis of pleural aspirate, and the interpretation of the biochemical parameters depends on whether the baby is feeding. The treatment involves dietary modification, the use of different types of drugs, chest tube drainage, pleurodesis or some other surgical intervention. There are no clinical trials to document the most effective treatment modality. Intrauterine interventions have been reported in some cases. We report a case of neonatal chylothorax to document the diagnostic challenges and management outcomes in a resource-limited setting.

Utilisation of a post-Fontan management pathway reduces chest tube drainage and hospital readmission rates.

Complications following the Fontan procedure include prolonged pleural drainage and readmission for effusions. To address these complications, a post-Fontan management pathway was implemented with primary goals of reducing chest tube duration/reinsertion rates and decreasing hospital length of stay and readmissions. Fontan patients were identified by retrospective chart review (2017-2019) to obtain baseline data for chest tube duration/reinsertion rates, hospital length of stay, and readmission rates for effusion. A post-Fontan management pathway was implemented (2020-2021) utilising post-operative vasopressin, nasal cannula oxygen until chest tube removal, and discharge regimen of three times daily diuretics, sildenafil, and afterload reducing medications. Patients were followed to evaluate primary outcomes. The pre- and post-pathway groups were similar in single ventricle morphology, demographics, and pre-operative haemodynamics. Forty-three and 36 patients were included in the pre- and post-pathway cohorts, respectively. There were statistically significant reductions in chest tube duration (8 vs. 5 days, p ≤ 0.001), chest tube output on post-operative day 4 (20.4 vs. 9.9 mL/kg/day, p = 0.003), and hospital readmission rates for effusion (13[30%] vs. 3[8%], p = 0.02) compared to baseline. There was an absolute reduction in hospital length of stay (11 vs. 9.5 days, p = 0.052). When combining average cost savings for the Fontan hospitalisations, readmissions for effusion, and cardiac catheterisations within 6 months of Fontan completion, there was a $325,144 total cost savings for 36 patients following pathway implementation. Implementation of a post-Fontan management pathway resulted in significant reductions in chest tube duration and output, and readmission rates for effusion in the perioperative period.

Effect of Incentive Spirometry on Respiratory Parameters among Critically Ill Patients with Chest Tube Drainage

Effect of Incentive Spirometry on Respiratory Parameters among Critically Ill Patients with Chest Tube Drainage

Retrospective Study on Anterolateral Mini-Thoracotomy in Emergency Surgical Drainage for Massive Pericardial Effusion Including Sternotomy Case

Background: The conventional method for managing the surgical drainage of an acute massive pericardial effusion typically involves a median sternotomy. Nevertheless, advancements in surgical optics and tools have enabled the utilization of progressively smaller incisions, such as a left anterolateral thoracotomy, for the same purpose. Aim of the Study: This study aimed to assess the surgical outcomes of left anterolateral mini-thoracotomy compared to median sternotomy for draining acute massive pericardial effusion. Methods: This research took place in the Cardiac Surgery Department at Ibrahim Cardiac and Research Institute, following approval from the local ethics committee, from June 2021 to June 2023. Fourteen patients with acute massive pericardial effusion necessitating emergency surgical drainage were included. The investigation concentrated on evaluating operative and short-term postoperative results to gauge the influence of two surgical drainage methods on patients' quality of life. Result: Both groups exhibited similar age, preoperative comorbidities, and ejection fraction. The sternotomy group required more operation time than the left anterolateral mini-thoracotomy group. Furthermore, the sternotomy group had a prolonged stay in the intensive care unit and hospital compared to the left anterolateral mini-thoracotomy group. Similar rates were observed for blood transfusion and chest tube drainage. However, two cases of superficial wound infection occurred in the sternotomy group. In the anterolateral thoracotomy group, no patients required conversion to full sternotomy, and all patients were alive at the one-month follow-up after hospital discharge. Conclusion: Employing a left anterolateral mini-thoracotomy for draining acute massive pericardial effusion was deemed a secure and reliable alternative to the traditional median sternotomy incision. Despite its limited operating field, requiring proficiency, this approach preserved sternal integrity, offered a more aesthetically pleasing incision, reduced the risk of wound infection, and decreased the need for analgesia. Additionally, it was associated with a faster recovery process and a shorter stay in the intensive care unit (ICU). (Bangladesh Heart Journal 2024; 39(2): 161-167