Video-Assisted Thoracic Surgery
Conditions
Keywords
Thoracoscopic surgery
Brief summary
Video-assisted thoracoscopic surgery (VATS) for thoracic surgery is practical, has been shown to reduce postoperative discomfort, and has improved cosmetic results when compare to open thoracotomy. The specific aims of this project are: to clarify the physiologic and immunologic effects of different approaches for minimally invasive thoracic surgery: (1) multiple-port VATS; (2) single-port VATS
Detailed description
Video-assisted thoracoscopic surgery (VATS) was first reported in the early 1990s. Since then, the safety and efficacy of thoracoscopy for diagnosing and treating pleural, pulmonary, and mediastinal disease has been demonstrated with similar oncological results, which were confirmed by multiple clinical studies. Although VATS for thoracic surgery is practical, has been shown to reduce postoperative discomfort, and has improved cosmetic results when compare to open thoracotomy, unfortunately chronic thoracic wound discomfort and postoperative neuralgia were found in a significant portion of patients . Recently, a minimally invasive approach that is different from the conventional multiport thoracoscopic technique is gradually becoming of great interest in the diagnosis and treatment of thoracic surgical disease. Single-port VATS is one of the most promising emerging surgical techniques which allows the surgeon to perform a majority of thoracic surgeries and with similar perioperative outcomes that are comparable with the conventional multiport technique. However, a very limited number of clinical studies have demonstrated the advantages of single port VATS in postoperative pain reduction, when comparing to the traditional multiport thoracoscopic approach. To clarify the physiologic and immunologic effects of different approaches for minimally invasive thoracic surgery, investigators aim to compare the perioperative physiological changes, immunological responses, and postoperative pain between standard (multi-port) transthoracic thoracoscopic and single-port transthoracic thoracoscopic surgery for thoracic disease.
Interventions
PROCEDUREmulti-port VATS
Patients with thoracic surgical diseases who underwent VATS will be recruited into this study to investigate the postoperative pain , physiologic and immunologic impacts of two different approaches for minimally invasive thoracic surgery.
PROCEDUREsingle-port VATS
Patients with thoracic surgical diseases who underwent VATS will be recruited into this study to investigate the postoperative pain , physiologic and immunologic impacts of two different approaches for minimally invasive thoracic surgery.
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient with thoracic surgical diseases(lung cancer. mediastinal tumor. solitary pulmonary lesion. pneumothorax) who will be underwent video-assisted thoracic surgery
Exclusion criteria
* Unresectable mediastinal tumor * Previous history of ipsilateral pulmonary resection * Patients with complex cardiopulmonary dysfunction * Unresectable pulmonary hilar tumor
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain score | beginning at 3 hours after surgery until 5 days | Numerical Rating Scale (NRS) or Wong-Baker Face Pain Rating Scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean arterial pressure | beginning 20 min before the start of surgery until 20 min after the surgery. | MAP; mmHg |
| Heart rate | beginning 20 min before the start of surgery until 20 min after the surgery. | HR; beats per min \[bpm\] |
| Cardiac index | beginning 20 min before the start of surgery until 20 min after the surgery. | CI; L/\[min·m2\] |
| Systemic vascular resistance index | beginning 20 min before the start of surgery until 20 min after the surgery. | SVRI; \[dyn·s\]/\[cm-5·m2\] |
| Global end-diastolic volume index | beginning 20 min before the start of surgery until 20 min after the surgery. | GEDVI; mL/m2 |
| Complication | beginning at 3 hours after surgery until 30 days | Yes/No |
| Intracellular oxidative activity of neutrophils | preoperation till 5 days after surgery | ratio compared with preoperation |
| Inducible nitric oxide synthase expression in monocytes | preoperation till 5 days after surgery | Arbitrary intensity |
| Interleukin-6 | preoperation till 5 days after surgery | pg/ml |
| C-reactive protein | preoperation till 5 days after surgery | ng/ml |
| Leukocyte subset analysis | preoperation till 5 days after surgery | 10\^3/ul |
Countries
Taiwan
Outcome results
None listed