A Comparative Study of Pigtail Catheter and Malecots Chest Tube Thoracostomy in the Management of Empyema Thoracis at a Tertiary Care Center in North India

Background: The study aimed to compare the effectiveness of pigtail catheter vs. malecot chest tube thoracostomy in the management of empyema thoracis and pyopneumothorax. Methods : This prospective randomised interventional study was conducted in the Department of Respiratory Medicine at a tertiary care centre in north India between September 2020 and August 2021. One hundred patients, qualified as per inclusion criteria, were included in the study, and randomization was done using the random number table method. After allocation concealment and randomization, the intervention was done in the sense that Group A (51 cases) received a pigtail catheter (14F) and Group B (49 cases) received a malecot chest tube (28F) (a total of 100 cases). After the intervention, both groups were observed for 14 days. On the 14th day, the data for the primary observations (radiological clearance on day 1, day 7, day 14th, and mean duration of hospital stay) and secondary observations (postoperative pain score, post-procedure complications) were noted, and statistical analysis was done. Results: Radiological clearance in the malecot chest tube group (28F) is better on days 1 (0.55±0.13) and 7 (0.75±0.08) than in the pigtail catheter group on day 1 (0.52±0.18) and day 7 (0.72±0.11). But, radiological clearance on day 14 in the malecot chest tube group (0.91±0.06) and the pigtail catheter group (0.91±0.08) is comparatively equal (p<0.05). The mean duration of hospital stay and pain scores were better in the pigtail catheter group than in the malecot chest tube group. Conclusions: Our study suggests pigtail catheters are a safe and effective method and should be considered in the management of empyema thoracis and pyopneumothorax