Lung Diseases
Conditions
Brief summary
Many thoracic surgeons tend to dissect the inferior pulmonary ligament (IPL) during upper lobectomy, which in theory reduces the free space in the upper thoracic cavity by increasing the mobility of the residual lung. However, the dissection of IPL may lead to bronchial deformation, stenosis, obstruction or lobe torsion, and distortion. Some studies have found that stenosis might be associated with chronic dry cough and shortness of breath, and could result in a significant decline in lung function. Moreover, the dissection of IPL may lead to greater surgical trauma and increase the incidence of complications. Therefore, this study tries to identify whether we should dissect or preserve the inferior pulmonary ligament during the thoracoscopic upper lobectomy.
Interventions
PROCEDUREDissection of the Inferior Pulmonary Ligament
Patients will be categorized into two groups: the division group ,who will receive the division of the inferior pulmonary ligament, and the preservation group, who will not.For the dissection group, we will dissect the inferior pulmonary ligament during the surgery.
PROCEDUREPreservation of the Inferior Pulmonary Ligament
Patients will be categorized into two groups: the division group ,who will receive the division of the inferior pulmonary ligament, and the preservation group, who will not.For the preservation group, we will preserve the inferior pulmonay ligament during the surgery.
Sponsors
Fuqing City Hospital
Sanming Second Hospital
Fujian Medical University Union Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. 18 years old \< age \< 70 years old; 2. Meet the indications for thoracoscopic left/right upper lobectomy; 3. Gave informed consent and were willing to undergo thoracoscopic left/right upper lobectomy; 4. Preoperative pulmonary function test: FEV1\>1L and FEV1\>60% of the predicted value; 5. Preoperative ECOG score of 0-1; 6. Preoperative ASA score I-II.
Exclusion criteria
1. Inferior mediastinal lymphadenopathy was found in preoperative screening; 2. Found that other lobe operations were required at the same time due to multiple lesions in the preoperative discussion; 3. Pregnant or lactating women; 4. Suffering from severe mental illness; 5. History of thoracic surgery (including intrathoracic surgery only, excluding surface surgery such as mastectomy); 6. History of unstable angina or myocardial infarction within the past six months; 7. History of cerebral infarction or cerebral hemorrhage within the past six months; 8. History of continuous systemic corticosteroid therapy within the past month; 9. Abnormal coagulation function, bleeding tendency, or receiving antithrombotic or antiplatelet therapy recently; 10. Suffering from severe liver, kidney, and other systemic diseases; 11. Other situations that are not suitable for surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in bronchial angle | 3 months after the operation | Change in bronchial angle of each arm(measured by coronal CT) |
| Change in lung volume | 3 months after the operation | Change in lung volume of each arm(measured by Mimics Research 21.0 software) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lung infection | Within 6 months after the operation | Lung infection incidence rate |
| Atrial fibrillation | During the postoperative hospital stay | Atrial fibrillation incidence rate |
| Operation time | During the operation | Operation time |
| Postoperative hospital stay | During the postoperative hospital stay | Postoperative hospital stay |
| Apical dead space | Within 6 months after the operation | Apical dead space incidence rate |
| Disposable drainage catheter retention time | Within one month after the operation | Disposable drainage catheter retention time |
| Pathologic cancer stage | After the operation | Pathologic cancer stage |
| Histologic diagnosis | After the operation | Histologic diagnosis |
| Closed thoracic drainage tube rentention time | During the postoperative hospital stay | Closed thoracic drainage tube rentention time |
| Pleural effusion | Within 6 months after the operation | Pleural effusion incidence rate |
Countries
China
Outcome results
None listed