Lung Diseases, Non-Neoplastic Thoracic Disorder
Conditions
Brief summary
prospective study, involves 60 patients underwent thoracoscopic surgery, the patients will be divided into two groups, the first group will undergo early chest tube removal - after three hours, the second group will have late chest tube removal according to the department's protocol. the study aims to prove the possibility and non inferiority for early chest tube removal for thoracoscopic surgeries with non complicated surgical course.
Detailed description
Presence of chest tube post thoracoscopic surgery is associated with increased morbidities like wound infection, pain, and prolong the hospital admission Corse, in the other hand, early chest tube removal is associated with increased the need for recurrent active intervention like pleural tapping for re-accumulated pleural effusion. Method: randomized prospective study includes 60 patients who underwent thoracoscopic lobectomy/segmentectomy/ thoracoscopic mediastinal biopsy. The study will exclude patients with difficult operative course ( intraoperative finding of significant adhesions/ intraoperative injury of the lung parenchyma/ intraoperative bleeding/failure of extubation ) and patient with post operative findings of ( bleeding in the chest tube more than 100 ml in the first hour, persistent air leak, non expanded lung on chest x-ray ) The patients will be divided into two groups, the first group - 30 patients - will undergo chest tube removal after three hours, and the second group will undergo chest tube removal according to the treating department protocol. All patients will be evaluated regarding the pain level - subjective and objective -, admission period, infection, and the need for invasive intervention. The patients will be evaluated during the admission, after one week and after two weeks.
Interventions
PROCEDUREChest tube removal
chest tube removal post thoracoscopic surgery
Sponsors
Rambam Health Care Campus
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* patient's who undergo thoracoscopic lung resection ( lobectomy or segmentectomy ), or thoracoscopic mediastinal biopsy. * post op there was no bleeding, the lung expanded, no persistent air leak, fluid discharge in the chest tube less than 100 ml, the patient underwent extubation. * patients with who read and signed informed consent regarding the participation of the study.
Exclusion criteria
* Patients who underwent thoracoscopic segmental resection due to primary spontaneous pneumothorax. * patients who underwent thoracoscopic pleural biopsy for possible malignancy. * patients under 18 year old.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Non complicated early chest tube removal | two weeks | the patient with inclusion criteria can undergo early chest tube removal after three hours with no need for chest tube insertion, or pleural tapping for recurrent pleural effusion, |
| Complicated early chest tube removal | two weeks | Patients who underwent early chest tube removal 3 hours after surgery are more liable for reinsertion of chest tube or active pleural tapping. |
Contacts
Primary ContactRan Kremer, MD
Backup ContactAmit Katz, MD
Outcome results
None listed