Pleural Effusion Recurrence, Pulmonary Resection, Chest Tube Management
Conditions
Brief summary
Previous studies have shown that the removal of the chest tube after lung surgery significantly improves pain symptoms and lung function. The criteria for chest tube removal still remain vague in modern thoracic surgery and rely on personal experience instead of evidence-based criteria. Every hospital has its own traditional standard fluid threshold and believes in that without adapting and comparing it not even after introduction of newer and more minimal-invasive operation technique. According to literature the traditional fluid threshold is varying from 100 to 500 or even more millilitre in 24 hours. Since pleural fluid resorption is proportional to body weight the investigators believe that a body weight related approach of chest tube management would improve safety and would allow an earlier chest tube removal without a higher rate of complication. In this way the investigators believe in improving pain management and in achieving earlier discharge of the patient.
Interventions
PROCEDURETraditional
Removal of the chest tube after air leakage has ceased and fluid drainage is 200ml/24h or less.
PROCEDURETest
Removal of the chest tube after air leakage has ceased and fluid drainage is 5ml/kg/24h or less.
Sponsors
Insel Gruppe AG, University Hospital Bern
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Caregiver)
Masking description
The operating surgeon does not know to which group the Patient will be attributed to.
Intervention model description
Group 1: Removal of the chest tube after air leakage has ceased and fluid Drainage is \< 200ml/24h Group 2: Removal of the chest tube after air leakage has ceased and fluid Drainage is \< 5ml/kg/24h
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Lobectomy/ Bilobectomy * Segmentectomy * Signed consent * Age of majority
Exclusion criteria
* Pneumonectomy * Atypical resections * Empyema * Pleural effusion (not related to surgery) * Pleurodesis * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of recurrent pleural effusions after chest tube removal | up to 6 weeks postoperative | Evaluation of recurrent pleural effusion after chest tube removal |
| Pain scores (VAS-Score) | postoperative Period until 3 hours after Chest tube removal | Evaluation of Pain Scores after Chest tube removal |
| Time Point of chest tube removal | Postoperative, expected to be up to 1 week after surgery | postoperative day of chest tube removal |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient discharge | At time of discharge, on average 4-7 days | Time Point of Patient discharge |
Countries
Switzerland
Outcome results
None listed