Thoracic Surgery, Video-Assisted
Conditions
Keywords
wedge resection, tubeless
Brief summary
This study evaluates the viability and safety of two-lumen catheterization versus chest tube placement in patients with lung wedge resection. Half of participants will receive routine chest tube placement, while the other half will receive a two-lumen central venous catheterization along the midclavicular line, second intercostal space for remedial gas-remove.
Detailed description
With the development of video-assisted thoracoscopic surgery (VATS) techniques, minimally invasive thoracic surgery has evolved considerably over the last three decades. The concept of tubeless involves non-intubated anesthesia with spontaneous ventilation and no chest tube placement. Chest tube placement always causes pain, and its duration is known to be one of the most important factors influencing hospital stay and costs. Early tube removal allows patients to breathe deeply with less pain, which leads to more compliance with chest physiotherapy, as demonstrated by a concomitant improvement in patients' ventilatory function. Hence, more and more experienced surgeons choose the omission of chest tube placement after lung wedge resection. However, based on previous retrospective studies, residual pneumothorax was noted in about 10\ 40% cases, and some of them need re-intervention. Hence, the investigators designed a intra-operative two-lumen catheterization for remedial gas-remove. Therefore, this study evaluates the viability and safety of two-lumen catheterization versus chest tube placement in patients with lung wedge resection.
Interventions
PROCEDUREchest tube
VATS with chest tube placement
PROCEDUREtwo-lumen catheterization
VATS with two-lumen catheterization long the midclavicular line, second intercostal space
DEVICEtwo-lumen catheter
central venous catheter(two-lumen 7-Fr-20cm)
Sponsors
Guangdong Provincial People's Hospital
Wen-zhao ZHONG
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Preoperative radiology revealed solitary peripheral pulmonary nodule, with both size and depth less than 3 cm 2. Lung wedge resection for tumor biopsy to elucidate drug resistant mechanism or confirm diagnosis
Exclusion criteria
1. Previous ipsilateral thoracic surgery or extensive adhesion 2. Preoperative radiology revealed pneumonia or atelectasis 3. Any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the previous year, serious cardiac arrhythmia requiring medication, hepatic, renal, or metabolic disease). 4. Bleeding tendency or anticoagulant use 5. Pregnancy or breast feeding 6. Patient who can not sign permit
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of post-operative related complications | 1 week | To evaluate the rate of post-operative related complications within 7 days of surgery |
| Postoperative adverse event incidence rate | 1 months | To evaluate the incidence rate of pneumothorax (a pneumothorax greater than 2.0 cm on X-ray) or pleural effusion (\>800ml) in both groups. |
| Length of post-operative hospital stay | 1 week | To evaluate the length of post-operative hospital stay |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pulmonary function recovery | 1 week | To evaluate the postoperative cardiopulmonary function recovery via 6-minute walk test in both groups. |
| Postoperative wound satisfaction | 1 month | To evaluate the post-operative wound healing condition . |
| Postoperative pain score | 1 day | To evaluate the pain score via NRS pain scale first day after surgery. |
| Postoperative pneumoderm incidence rate | 3 days | To evaluate the postoperative pneumoderm incidence rate in both groups. |
| The time of post-operative extubation | 1 week | To evaluate the time of duration of chest tube or catheterization. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Characteristics of plasma exosome for the solitary pulmonary nodules | 1 month | We prospectively collect the preoperative plasma sample of patients with solitary pulmonary nodule in this study to determine the diagnostic value and molecular characteristics of plasma exosome-derived miRNAs for these patients. |
Countries
China
Contacts
Primary ContactWen-Zhao Zhong
Backup ContactSong Dong
Outcome results
None listed