Pleural fluid collections and ultrasound guided percutaneous drainage Ann. Ital. Chir., 81, 6, 2010 429 Ann. Ital. Chir., 2010 81: 429-432 Introduction The presence of fluid collection in the pleural cavity is a frequent clinical problem that requires drainage for diagnostic and therapeutic purposes. In the past many retrospective and prospective studies reported complica- tions related to pleural fluid collection drainage 1-4 . Actually, ultrasonography (US) represents an important diagnostic imaging technique; it is not expensive and is easy to perform. It can also supply correct information on the size and location of the pleural fluid collection, and on the relationship with other anatomic structures. Aim of our study is the retrospective evaluation of our experience in diagnostic and therapeutic thoracic drainage, to stress the cause of failure and to emphasise the cost-effectiveness of the technique. Materials and methods We retrospectively studied patients hospitalized in our Departement from January 1995 to May 2009, for pleu- ral fluid collection. 564 therapeutic and diagnostic US guided percutaneous drainages of pleural fluid collections were performed from January 1995 to May 2009; 63.8% were males and 36.2% females; the age ranged from 33 to 82 years; median age was 51 years. Pervenuto in Redazione Agosto 2010. Accettato per la pubblicazione Ottobre 2010 Per corrispondenza: Dott. Girolamo Geraci, Ricercatore Universitario, Università degli Studi di Palermo, Sezione di Chirurgia Generale ad Indirizzo Toracico (Direttore: Prof. Giuseppe Modica) (e-mail:ggera- ci@unipa.it) Massimo Cajozzo, Girolamo Geraci, Chiara Lo Nigro, Manuela Palazzolo, Francesco Raffaele, Roberto Pinna, Marta Cajozzo, Giuseppe Modica. Department of Surgery and Oncology, Operative Unit of General and Thoracic Surgery, University of Palermo, Palermo, Italy Pleural fluid collections and ultrasounds guided percutaneous drainage INTRODUCTION: The presence of fluid collection in the pleural cavity is a frequent clinical problem that requires drainage for diagnostic and therapeutic purposes. Aim of our study is the retrospective evaluation of our experience in diagnostic and therapeutic thoracic drainage, to stress the cause of failure and to emphasise the cost-effectiveness of the technique. MATERIALS AND METHODS: From January 1995 to May 2009, 564 therapeutic and diagnostic ultrasound (US) guided percutaneous drainages of pleural fluid collection were performed in 412 patients. RESULTS: The macroscopic, biochemical, cytological and microbiological examination of the drained fluid diagnosed the presence of 80 (19.4%) transudates, 101 (24.5%) non neoplastic exudates, 55 (13.4%) neoplastic exudates, 152 (36.9%) empyema and 24 (5.8%) haemothorax. There were no major complications. Minor complications were present in 23/564 cases (4.0 %). CONCLUSIONS: The US guided puncture of the pleural fluid collection allows a high rate of success (in correct detection and drainage of chronic pleural effusions), reduces the rate of complications and is well accepted by patients. KEY WORDS: Pleural fluid collections, Ultrasound guided percutaneous drainage.