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

Status: Recruiting
Location: See location...
Intervention Type: Procedure
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Chest tube thoracostomy remains a lifesaving intervention in trauma and thoracic surgery, used for the management of pneumothorax, hemothorax, empyema, and pleural effusions. Despite being one of the most frequently performed procedures worldwide, complication rates remain high, ranging from 20% to 40% \[1\]. Among these, pulmonary parenchymal chest tube (PPcT) insertion represents a rare but potentially devastating event, leading to hemorrhage, air leak, bronchopleural fistula, or infection. In Pakistan, where chest trauma and pneumothorax constitute major thoracic morbidities, PPcT cases are encountered with increasing frequency but remain underreported. Current literature describes only invasive surgical approaches-such as thoracotomy or video-assisted thoracic surgery (VATS)-for PPcT removal \[9,10\], with no established minimally invasive alternatives. In response to this clinical challenge, the Department of Thoracic Surgery at (Hospital Name), Punjab, Pakistan, has developed and implemented a novel, minimally invasive three-stage removal technique, termed the Buzdar Technique, designed to ensure safe extraction of intraparenchymal chest tubes without surgical intervention. The technique follows a standardized protocol involving: Healing phase: Tube left in situ for approximately two weeks to allow localized fibrosis and stabilization of the lung parenchyma. Initial retraction: Gradual 2-cm withdrawal with optional 360° rotation under radiologic and clinical supervision, followed by 24-hour observation and chest imaging. Sequential retractions: Weekly staged retractions of 2 cm until the last fenestration exits the pleural cavity, enabling safe final removal. This prospective cohort study, conducted from July 2025 to June 2026, aims to evaluate the safety, effectiveness, and clinical outcomes of the Buzdar Technique in managing iatrogenic PPcT. Data will include patient demographics, procedural details, complications, radiologic recovery, and overall outcomes. Success will be defined as complete tube removal without pneumothorax, air leak, bleeding, or need for surgical intervention. Preliminary institutional experience over the past decade has shown excellent results, with minimal morbidity, no requirement for thoracotomy or VATS, and full radiologic recovery in the majority of patients. The expected outcomes of this prospective evaluation are to validate these findings, establish the Buzdar Technique as a reproducible, evidence-based approach, and contribute to the global literature on non-surgical management of PPcT. If proven effective, this technique could represent a paradigm shift in the management of intraparenchymal chest tubes-offering a safe, staged, and minimally invasive alternative to surgical removal, particularly beneficial for centers in low- and middle-income countries where advanced surgical options may not always be available.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Patients ≥18 years with confirmed intraparenchymal chest tube placement on chest CT or X-ray.

• Hemodynamically stable patients suitable for conservative staged removal.

• Patients providing informed consent.

Locations
Other Locations
Pakistan
Services Hospital Lahore
RECRUITING
Lahore
Contact Information
Primary
Zeeshan Sarwar, MBBS
zeeshan.sarwar195@gmail.com
+92 3214347410
Time Frame
Start Date: 2025-07-01
Estimated Completion Date: 2027-09-30
Participants
Target number of participants: 300
Treatments
Experimental: Pulmonary Parenchymal Tube Group
The Buzdar Technique is a standardized, three-stage, minimally invasive approach designed to safely remove intraparenchymal chest tubes without thoracotomy or VATS. It aims to promote controlled fibrosis and gradual parenchymal healing before complete tube withdrawal.
Related Therapeutic Areas
Sponsors
Leads: University of Health Sciences Lahore

This content was sourced from clinicaltrials.gov